Impulse oscillometry in children and adolescents with persistent asthma and its correlation with spirometry

Main Article Content

Jales Henrique Pereira de Lima
Patrícia Polles de Oliveira Jorge
Dirceu Solé
Gustavo Falbo Wandalsen

Keywords

Asthma, Child, Oscillometry, Respiratory Function Tests, Spirometry

Abstract

Introduction: Asthma is one of the most common chronic diseases of childhood. Spirometry is the traditional test for assessing lung function, while impulse oscillometrics is an alternative resource that measures the impedance of the respiratory system.


Objective: To evaluate the pulmonary function of children and adolescents with asthma by impulse oscillometry and correlate the findings with those obtained by spirometry.


Methods: A cross-sectional study in which the pulmonary function of asthmatic children and adolescents aged between 6 and 18 years was evaluated, categorized by the level of disease control according to the Asthma Control Test (ACT) or Children Asthma Control Test (C-ACT) into controlled (ACT/C-ACT>19; n = 70) and uncontrolled (ACT/C-ACT ≤ 19; n = 60).


Results: A total of 130 asthmatic children and adolescents were evaluated (51% were males). There were no significant differences in the parameter values of both tests when patients were divided by the level of asthma control. Altered impulse oscillometry and spirometry were performed in 20 and 25% of the cases, respectively. Changes in impulse oscillometry were more frequent in patients with controlled asthma. R5 (%), X5 (%), and Fres showed moderate correlation with the main spirometric parameters, being stronger between X5 (%) and FEV1/FVC (%) (r: -0,58; P < 0,05) in patients with controlled asthma. Bronchodilator response was observed in a similar number of patients in both exams, but with reasonable agreement.


Conclusions: Impulse oscillometry values showed a weak or moderate correlation with spirometry values.

Abstract 493 | PDF Downloads 489 HTML Downloads 19 XML Downloads 36

References

1. Foliaki S, Annesi-Maesano I, Daniel R, Fakakovikaetau T, Magatongia M, Tuuau-Potoi N, et al. Prevalence of symptoms of childhood asthma, allergic rhinoconjunctivitis and eczema in the Pacific: The International Study of Asthma and Allergies in Childhood (ISAAC). Allergy. 2007;62(3):259–64. 10.1111/j.1398-9995.2007.01343.x

2. Fontes MJ, Affonso AG, Calazans GM, de Andrade CR, Lasmar LM, Nader CM, et al. Impact of an asthma management program on hospitalizations and emergency department visits. J Pediatr (Rio J). 2011;87(5):412–8. 10.2223/JPED.2129

3. Sociedade Brasileira de Pneumologia e Tisiologia. Diretrizes da Sociedade Brasileira de Pneumologia e Tisiologia Para o Manejo da Asma. J Bras Pneumol. 2012;38:S1–S46. 10.1590/S1806-37132012000300002

4. GINA. Pocket Guide for asthma management and prevention. Global Initiative for Asthma 2020 [Internet]. [Citado 2021 Julho 17]. Disponível a partir de: www.ginasthma.org

5. GINA. Pocket guide for asthma management and prevention. Global Initiative for Asthma 2021 [Internet]. [Citado 2021 Julho 17]. Disponível a partir de: www.ginasthma.org

6. Solé D, Camelo-Nunes IC, Wandalsen GF, Naspitz CK, Vanna AT, Amorim A, et al. A asma em crianças brasileiras é problema de saúde pública? Rev Bras Alerg Imunopatol. 2004;27(5):185–88.

7. Linares M, Sánchez I, Corrales R, Díaz A, Escobar AM. Pruebas de función pulmonar en el niño. Rev Chil Pediatr. 2000;71(3):228–42. 10.4067/S0370-4106200000 0300010

8. IV Diretrizes Brasileiras para o Manejo da Asma. J Bras. Pneumol. 2007;32:S447–S474. 10.1590/S1806-37132006001100002

9. Belgrave DC, Buchan I, Bishop C, Lowe L, Simpson A, Custovic A. Trajectories of lung function during childhood. Am J Respir Crit Care Med. 2014;189(9):1101–9. 10.1164/rccm.201309-1700OC

10. Al-Mutairi SS, Sharma PN, Al-Alawi A, Al-Deen JS. Impulse oscillometry: An alternative modality to the conventional pulmonary function test to categorise obstructive pulmonary disorders. Clin Exp Med. 2007;7(2):56–64. 10.1007/s10238-007-0126-y

11. Marotta A, Klinnert MD, Price MR, Larsen GL, Liu AH. Impulse oscillometry provides an effective measure of lung dysfunction in 4-year-old children at risk for persistent asthma. J Allergy Clin Immunol. 2003;112(2):317–22. 10. 1067/mai.2003.1627

12. Valle E. Resistência das vias aéreas: Técnica da oscilação forçada. J Pneumol. 2002;28(Supl 3):151–54.

13. Beydon N, Davis SD, Lombardi E, Allen JL, Arets HG, Aurora P, et al. An official American Thoracic Society/European Respiratory Society statement: Pulmonary function testing in preschool-children. Am J Respir Crit Care Med. 2007;175(12):1304–45. 10.1164/rccm.200605-642ST

14. Goldman MD. Clinical application of forced oscillation. Pulm Pharmacol Ther. 2001;14(5):341–50. 10.1006/pupt.2001.0310

15. Hellinckx J, De Boeck K, Bande-Knops J, van der Poel M, Demedts M. Bronchodilator response in 3–6.5 years old healthy and stable asthmatic children. Eur Respir J. 1998;12(2):438–43. 10.1183/09031936.98.12020438

16. Oliveira Jorge PP, Lima JHP, Chong E Silva DC, Medeiros D, Solé D, Wandalsen GF. Impulse oscillometry in the assessment of children's lung function. Allergol Immunopathol (Madr). 2019;47(3):295–302. 10.1016/j.aller.2018.03.003

17. Vogel J, U Smith. Impulse Oscillometry-pmi Verlags Gmbh, Frankfurt am Main 1994.

18. Frei J, Jutla J, Kramer G, Hatzakis GE, Ducharme FM, Davis GM. Impulse oscillometry: Reference values in children 100 to 150 cm in height and 3 to 10 years of age. Chest. 2005;128(3):1266–73. 10.1378/chest.128.3.1266

19. Pereira CA. Espirometria. J Pneumol. 2002;28(3):S1–S82.

20. Komarow HD, Skinner J, Young M, Gaskins D, Nelson C, Gergen PJ, et al. A study of the use of impulse oscillometry in the evaluation of children with asthma: Analysis of lung parameters, order effect, and utility compared with spirometry. Pediatr Pulmonol. 2012;47(1):18–26. 10.1002/ppul.21507

21. Kim CW, Kim JS, Park JW, Hong CS. Clinical applications of forced oscillation techniques (FOT) in patients with bronchial asthma. Korean J Intern Med. 2001;16(2):80–6. 10.3904/kjim.2001.16.2.80

22. Nielsen KG, Bisgaard H. Discriminative capacity of bronchodilator response measured with three different lung function techniques in asthmatic and healthy children aged 2 to 5 years. Am J Respir Crit Care Med. 2001;164(4):554–9. 10.1164/ajrccm.164.4.2006119

23. Qi GS, Zhou ZC, Gu WC, Xi F, Wu H, Yang WL, et al. Detection of the airway obstruction stage in asthma using impulse oscillometry system. J Asthma. 2013;50(1):45–51. 10.3109/02770903.2012.743154

24. Song TW, Kim KW, Kim ES, Kim KE, Sohn MH. Correlation between spirometry and impulse oscillometry in children with asthma. Acta Paediatr. 2008;97(1):51–4. 10.1111/j.1651-2227.2007.00526.x

25. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–68. 10.1183/09031936.05.00035205

26. Shi Y, Aledia AS, Tatavoosian AV, Vijayalakshmi S, Galant SP, George SC. Relating small airways to asthma control by using impulse oscillometry in children. J Allergy Clin Immunol. 2012;129(3):671–8. 10.1016/j.jaci.2011.11.002

27. Shi Y, Aledia AS, Galant SP, George SC. Peripheral airway impairment measured by oscillometry predicts loss of asthma control in children. J Allergy Clin Immunol. 2013;131(3):718–23. 10.1016/j.jaci.2012.09.022

28. Wang X, Dockery DW, Wypij D, Fay ME, Ferris BG Jr. Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol. 1993;15(2):75–88. 10.1002/ppul.1950150204

29. Voorend-van Bergen S, Vaessen-Verberne AA, Landstra AM, Brackel HJ, van den Berg NJ, Caudri D, et al. Monitoring childhood asthma: Web-based diaries and the asthma control test. J Allergy Clin Immunol. 2014;133(6):1599–605. 10.1016/j.jaci.2013.10.005

30. Rodrigues JC, Cardieri JMA, Bussamra MHCF, Nakaie CMA, Almeida MB, Silva F° LVF, et al. Provas de função pulmonar em crianças e adolescentes. J Pneumol. 2002;28(Supl 3):S207–S221.

31. Lange P, Scharling H, Ulrik CS, Vestbo J. Inhaled corticosteroids and decline of lung function in community residents with asthma. Thorax. 2006;61(2):100–4. 10.1136/thx.2004.037978

32. Quanjer PH, Weiner DJ, Pretto JJ, Brazzale DJ, Boros PW. Measurement of FEF25–75% and FEF75% does not contribute to clinical decision making. Eur Respir J. 2014;43(4):1051–8. 10.1183/09031936.00128113

33. Lauhkonen E, Riikonen R, Törmänen S, Koponen P, Nuolivirta K, Helminen M, et al. Impulse oscillometry at preschool age is a strong predictor of lung function by flow-volume spirometry in adolescence. Pediatr Pulmonol. 2018;53(5):552–8. 10.1002/ppul.23977

34. Vink GR, Arets HG, van der Laag J, van der Ent CK. Impulse oscillometry: A measure for airway obstruction. Pediatr Pulmonol. 2003;35(3):214–9. 10.1002/ppul.10235

35. Moreau L, Crenesse D, Berthier F, Albertini M. Relationship between impulse oscillometry and spirometric indices in cystic fibrosis children. Acta Paediatr. 2009;98(6):1019–23. 10.1111/j.1651-2227.2009.01246.x

36. Wei X, Shi Z, Cui Y, Mi J, Ma Z, Ren J, et al. Impulse oscillometry system as an alternative diagnostic method for chronic obstructive pulmonary disease. Medicine (Baltimore). 2017;96(46):1–12. 10.1097/MD.0000000000008543

37. Su ZQ, Guan WJ, Li SY, Ding M, Chen Y, Jiang M, et al. Significances of spirometry and impulse oscillometry for detecting small airway disorders assessed with endobronchial optical coherence tomography in COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:3031–44. 10.2147/COPD.S172639

38. Malmberg LP, Pelkonen A, Poussa T, Pohianpalo A, Haahtela T, Turpeinen M. Determinants of respiratory system input impedance and bronchodilator response in healthy Finnish preschool children. Clin Physiol Funct Imaging. 2002;22(1):64–71. 10.1046/j.1365-2281.2002.00396.x

39. Peirano R. Oscilometría de impulso (IOS) en niños. Neumol Pediátr. 2010;5(2):89–95.