Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May;59(5):1321-1329.
doi: 10.1002/ppul.26909. Epub 2024 Feb 14.

Impulse oscillometry bronchodilator response in preschool children

Aniello Meoli  1   2 , Jordis Trischler  1 , Martin Hutter  1 , Melanie Dressler  1 , Susanna Esposito  2 , Katharina Blümchen  1 , Stefan Zielen  1 , Johannes Schulze  1
Affiliations

Impulse oscillometry bronchodilator response in preschool children

Aniello Meoli et al. Pediatr Pulmonol. 2024 May.

Abstract

Background: In preschoolers, performing an acceptable spirometry and measuring bronchodilator response (BDR) is challenging; in this context, impulse oscillometry (IOS) represents a valid alternative. However, more studies on the standardization of BDR for IOS in young children are required.

Objective: The objective of the study was to identify optimal thresholds to define a positive BDR test with IOS in preschoolers with suspected asthma.

Methods: Children aged 3-6 years with suspected asthma and their lung function investigated with both IOS and spirometry pre- and post-BDR were retrospectively analyzed. The spirometric BDR was defined as positive when the change of FEV1 was ≥12% or ≥200 mL. The oscillometric BDR was defined as positive in case of change of at least -40% in R5, +50% in X5, and -80% in AX.

Results: Among 72 patients, 36 (age 5.2 ± 1 years; 64% boys) were selected for the subsequent analysis according to ATS/ERS quality criteria of measurements; specifically, 19 patients did not meet IOS and 36 did not meet spirometry criteria. The spirometric BDR was found positive in seven subjects (19.4%); conversely, a positive oscillometric BDR was identified in four patients (11.1%). No patient presented a positive BDR response with both methods. In IOS, the mean decrease in R5 and AX was 19.9% ± 10% and 44% ± 22.1%, and the mean increase in X5 was 23.3% ± 17.8%, respectively. A decrease in R5 of 25.7% (AUC 0.77, p = .03) and an increase in X5 of 25.7% (AUC 0.75, p = .04) showed the best combination of sensitivity and specificity to detect an increase of FEV1 ≥ 12% and/or ≥200 mL.

Conclusion: The IOS represents a valid alternative to spirometry to measure BDR in preschool children and should be the gold standard in this age group. We are considering a decrease of 26% in R5 and an increase of 26% in X5 as diagnostic threshold for BDR.

Keywords: bronchodilator response; oscillometry; preschool asthma; spirometry.

PubMed Disclaimer

References

REFERENCES

    1. Global Initiative for Asthma. Global strategy for asthma management and prevention. 2022. Accessed November 10, 2022. https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-F...
    1. Gaillard EA, Kuehni CE, Turner S, et al. European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5‐16 years. Eur Respir J. 2021;58(5):2004173. doi:10.1183/13993003.04173-2020
    1. Patel SJ, Teach SJ. Asthma. Pediatr Rev. 2019;40(11):549‐567. doi:10.1542/pir.2018-0282
    1. Achakulwisut P, Brauer M, Hystad P, Anenberg SC. Global, national, and urban burdens of paediatric asthma incidence attributable to ambient NO2 pollution: estimates from global datasets. Lancet Planet Health. 2019;3(4):e166‐e178. doi:10.1016/S2542-5196(19)30046-4
    1. Castro‐Rodriguez JA, Forno E, Padilla O, Casanello P, Krause BJ, Borzutzky A. The asthma predictive index as a surrogate diagnostic tool in preschoolers: analysis of a longitudinal birth cohort. Pediatr Pulmonol. 2021;56(10):3183‐3188. doi:10.1002/ppul.25592

Substances

Grants and funding