Lung function and bronchodilator response in 4-year-old children with different wheezing phenotypes

Oostveen, Ellie; Dom, Sandra; Desager, Kristine; Hagendorens, Margo M.; Backer, W. De; Weyler, J.

doi:10.1183/09031936.00023409

Cited by 85 publications

(109 citation statements)

References 34 publications

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“…Knowing the reference equation it is possible to detect abnormal lung function and, as previously mentioned, FOT can then be used in the follow-up of children with lung diseases such as asthma, neonatal chronic lung disease, or cystic fibrosis or asthma. 5,[7][8][9][13][14] The reference equations calculated from the healthy Italian children in the present study are very similar to those published by Hall et al 18 from Australian children Pediatric Pulmonology 18 to calculate Z-scores for Italian children and comparing them with Z-scores calculated using the Italian equations from the present study, no Pediatric Pulmonology Fig. 2.…”

Section: Discussionsupporting

confidence: 75%

“…Other studies have reported similar changes in lung function following bronchodilatation measured with FOT in asthmatic children 13 or with different wheezing phenotypes. 14 In conclusion, the data from the present study give the reference equation for R rs and X rs for Italian children between 2 and 6 years of age. The data also demonstrate that healthy Italian preschool children have similar lung function, as assessed by the FOT using the similar commercially available equipment, to healthy Australian preschool children.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it is not surprising that we found a relationship between the magnitude of the BDR and both baseline lung function and height. Oostveen et al 14 have recently argued that using absolute change in lung function to express BDR avoids hiding differences in baseline bronchomotor tone, which they implied underlies the difference in baseline lung function in children with different wheeze phenotypes. However, as argued by Thamrin et al 22 correcting for differences in airway caliber due to size rather than underlying bronchomotor tone is critical to getting the clinical interpretation correct.…”

Section: Discussionmentioning

confidence: 99%

“…[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. In the present study, we measured lung function using FOT in 163 preschool aged Italian children to produce reference equations for R rs and X rs and to compare these with the Australian data.…”

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: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Respiratory impedance and bronchodilator response in healthy Italian preschool children

Calogero¹,

Parri²,

Baccini³

et al. 2010

Pediatric Pulmonology

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Input oscillometry and the forced oscillation technique for assessing lung function in preschool children with asthma

Allen

2018

Pediatric Investigation

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Preschool children with asthma present a challenge in lung function testing, as they cannot readily cooperate with spirometry. The forced oscillation technique (FOT) measures passive pressures and flows delivered by a loudspeaker to a facemask, at frequencies much higher than those occurring physiologically. This in turn allows for rapid collection of data from a spontaneously breathing child in a timespan of seconds. However, at very rapid oscillatory flow rates, the mechanical properties opposing flows into and out of the respiratory system (collectively termed the respiratory system impedance, and comprised of elastic, resistive and inertial components) are very different from at normal breathing frequencies, with elastic properties being less important and inertial properties being more important. An understanding of how the respiratory system behaves at high frequencies is essential to understanding the physiological basis of this technique. This article presents a way to understand these oscillatory mechanics of the respiratory system. It then describes studies of the FOT in normal preschool children and in children with asthma. The technique can also measure the separate contributions of the central and peripheral airways, as well as assess for changes after bronchodilator administration. The FOT holds promise for the objective measurement of lung function in children who are too young to reliably perform spirometry.

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Bronchodilator responsiveness assessed by forced oscillometry and multiple breath washout techniques in preschool children

Friedman

McDonough

Zhang

et al. 2018

Pediatric Investigation

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Importance: The forced oscillation (FOT) and multiple breath washout (MBW) techniques are passive tests of lung function, and are reliable for preschool-age children. There has not been comparison testing to determine which test could more accurately differentiate between healthy controls and poorly controlled asthmatics, or differentiate a response to bronchodilator administration. Objective: To determine whether the MBW and/or FOT could differentiate between healthy controls and poorly controlled asthmatics, and whether the two tests could detect a response to bronchodilator administration. Methods: Twenty-eight healthy controls and 23 poorly controlled asthmatics 3-6 years of age participated. All subjects were administered the MBW followed by the FOT. A bronchodilator was then administered and testing was repeated. Wilcoxon Rank Sum tests were used to compare the difference between healthy controls and poorly controlled asthmatics. Wilcoxon Signed Rank tests were used to compare the pre-and postbronchodilator values. Results: Neither MBW nor FOT differentiated healthy controls from poorly controlled asthmatics (pre-bronchodilator data); both groups had similar baseline gas mixing and airway mechanics. There was no improvement in any MBW outcomes post-bronchodilator administration. FOT detected a significant and similar degree of improvement in the airway mechanics in both groups. Interpretation: Neither MBW nor FOT differentiated between poorly controlled asthmatics (when well) and healthy controls. MBW did not detect a significant bronchodilator response in either subject group, whereas FOT detected a similar degree of bronchodilator responsiveness in both groups. This discrepancy may reflect differential changes in airway mechanics and gas mixing properties in response to bronchodilators.

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Lung function and bronchodilator response in 4-year-old children with different wheezing phenotypes

Cited by 85 publications

References 34 publications

Respiratory impedance and bronchodilator response in healthy Italian preschool children

Respiratory impedance and bronchodilator response in healthy Italian preschool children

Input oscillometry and the forced oscillation technique for assessing lung function in preschool children with asthma

Bronchodilator responsiveness assessed by forced oscillometry and multiple breath washout techniques in preschool children

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