Assessment of bronchodilator responsiveness in preschool children using forced oscillations

Thamrin, Cindy; Gangell, Catherine; Udomittipong, Kanokporn; Kusel, Merci; Patterson, Hilary; Fukushima, Toshirou; Schultz, André; Hall, Graham L.; Stick, Stephen M.; Sly, Peter D.

doi:10.1136/thx.2006.071290

Cited by 88 publications

(129 citation statements)

References 24 publications

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“…In the present study, we assessed BDR using R rs and X rs at 8 Hz as these were previously recommended by Thamrin et al 10 Our data onfirm their earlier data that the change in both R rs and X rs following bronchodilator was related to the magnitude of the baseline values. In our study, we have found a correlation between BDR expressed as a percent of baseline and height for R rs8 .…”

Section: Discussionsupporting

confidence: 68%

“…This finding is similar to that reported by the Australian group. 18 The major difference between our study and the one from Thamrin et al 10 is the use of 600 mg of salbutamol to assess BDR whereas 200 mg was used in the present study. Despite this difference, the change in both R rs8 and X rs8 Pediatric Pulmonology Fig.…”

Section: Discussioncontrasting

confidence: 42%

“…The between-measurement coefficient of repeatability (CR, i.e., twice the standard deviation of the difference between two measurements) for FOT has been reported in healthy children to be between 1.1 and 2.6 hPa s L À1 for respiratory resistance (R rs ) and between 1.2 and 1.7 hPa s L À1 for respiratory reactance (X rs ). [18][19][20] Thamrin et al 10 have shown BDR calculated as a percent change with respect to baseline of À37% for R rs8 and 67% for X rs8 in healthy Australian children. Oostveen et al 14 have reported a decrease in resistance on average of 22% in wheezing children.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] FOT has also been shown to be a valid tool in the assessment of bronchodilator response (BDR) in different populations of patients, especially asthmatic or wheezing children. 4,[10][11][12][13][14] Before FOT can be introduced into clinical practice as a routine test, appropriate reference values from healthy populations are needed. Although, a number of data sets from children have been published these are likely to be specific to the equipment used and to the study population.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory impedance and bronchodilator response in healthy Italian preschool children

Calogero¹,

Parri²,

Baccini³

et al. 2010

Pediatric Pulmonology

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Summary. Objective: To define normal values for respiratory resistance (R rs ) and reactance (X rs ) and bronchodilator response (BDR) in a population of healthy Italian preschool children using a commercially available forced oscillation device. Methods: R rs and X rs were measured in kindergartens in Viterbo, Italy. Regression analysis was performed taking into account height, weight, age, gender, and reference equations calculated. The coefficient of repeatability (CR) between two tests performed 15 min apart was calculated in a subset of children. BDR was assessed by repeating the measurements 15 min after the administration of 200 mg of inhaled salbutamol and calculated as an absolute change in R rs and X rs at 8 Hz, as a percent change in baseline, and as a change in Z-score calculated from the reference equations. Results: Lung function was attempted in 175 healthy children and successful in 163 (81 male, median age 4.8, range 2.9-6.1 years). R rs and X rs at 6, 8, and 10 Hz were related to height but not other variables. The CR was 1.53 hPa s L À1 for R rs8 and 0.91 hPa s L À1 for X rs8 . The 5th percentile for absolute R rs8 BDR was À3.16 hPa s L À1, whereas the 95th percentile for absolute X rs8 BDR was 2.25 hPa s L À1. These cut-off values corresponded to a change in the Z-score of À1.88 and 2.48, respectively. Conclusions: We have established reference equations for R rs and X rs in healthy Italian preschool children using forced oscillations. We recommend a change in Z-score of À1.88 for R rs8 and 2.48 for X rs8 as cut-off values for a positive BDR.

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Section: Discussionsupporting

confidence: 68%

Section: Discussioncontrasting

confidence: 42%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Respiratory impedance and bronchodilator response in healthy Italian preschool children

Calogero¹,

Parri²,

Baccini³

et al. 2010

Pediatric Pulmonology

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“…Measurements of PEF on a day-to-day basis may allow monitoring of the variable airway obstruction, which is considered one of the key features of asthma and the variability in PEF may be predictive of exacerbations [16,32]. The mean day-to-day variability of peak flow in healthy children is between 6.2% and 8.2%, with a 95th percentile of 12.3-31% [33,34].…”

Section: Measurement Of Peak Flowmentioning

confidence: 99%

Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation

et al. 2015

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This review focuses on the methods available for measuring reversible airways obstruction, bronchial hyperresponsiveness (BHR) and inflammation as hallmarks of asthma, and their role in monitoring children with asthma. Persistent bronchial obstruction may occur in asymptomatic children and is considered a risk factor for severe asthma episodes and is associated with poor asthma outcome. Annual measurement of forced expiratory volume in 1 s using office based spirometry is considered useful. Other lung function measurements including the assessment of BHR may be reserved for children with possible exercise limitations, poor symptom perception and those not responding to their current treatment or with atypical asthma symptoms, and performed on a higher specialty level. To date, for most methods of measuring lung function there are no proper randomised controlled or large longitudinal studies available to establish their role in asthma management in children.Noninvasive biomarkers for monitoring inflammation in children are available, for example the measurement of exhaled nitric oxide fraction, and the assessment of induced sputum cytology or inflammatory mediators in the exhaled breath condensate. However, their role and usefulness in routine clinical practice to monitor and guide therapy remains unclear, and therefore, their use should be reserved for selected cases. @ERSpublications Review on the role of lung function, measurement of BHR and airway inflammation in monitoring of children with asthma

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Oscillation Mechanics of the Respiratory System

Bates

Irvin

Farré

et al. 2011

Comprehensive Physiology

186

182

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The mechanical impedance of the respiratory system defines the pressure profile required to drive a unit of oscillatory flow into the lungs. Impedance is a function of oscillation frequency, and is measured using the forced oscillation technique. Digital signal processing methods, most notably the Fourier transform, are used to calculate impedance from measured oscillatory pressures and flows. Impedance is a complex function of frequency, having both real and imaginary parts that vary with frequency in ways that can be used empirically to distinguish normal lung function from a variety of different pathologies. The most useful diagnostic information is gained when anatomically based mathematical models are fit to measurements of impedance. The simplest such model consists of a single flow-resistive conduit connecting to a single elastic compartment. Models of greater complexity may have two or more compartments, and provide more accurate fits to impedance measurements over a variety of different frequency ranges. The model that currently enjoys the widest application in studies of animal models of lung disease consists of a single airway serving an alveolar compartment comprising tissue with a constant-phase impedance. This model has been shown to fit very accurately to a wide range of impedance data, yet contains only four free parameters, and as such is highly parsimonious. The measurement of impedance in human patients is also now rapidly gaining acceptance, and promises to provide a more comprehensible assessment of lung function than parameters derived from conventional spirometry.

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Assessment of bronchodilator responsiveness in preschool children using forced oscillations

Cited by 88 publications

References 24 publications

Respiratory impedance and bronchodilator response in healthy Italian preschool children

Respiratory impedance and bronchodilator response in healthy Italian preschool children

Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation

Oscillation Mechanics of the Respiratory System

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