Reference values for respiratory sinusoidal oscillometry in children aged 3 to 17 years

Abstract

Background New oscillometry devices allowing quantification of respiratory function using tidal breathing are commercially available, but reference equations are lacking for the multiethnic Canadian pediatric population. Methods We conducted a prospective cross‐sectional study of healthy children carefully selected for absence of asthma, atopy, tobacco smoke, obesity, prematurity, and recent respiratory infection. Triplicate measures were obtained of respiratory system resistance (Rrs) and reactance (Xrs), area under the reactance curve (AX) and resonant frequency (Fres) on four signals, whose testing order was randomized: two signals on the Resmon Pro Full (8 Hz and 5‐11‐19 Hz) and two signals on the tremoflo C‐100 (5–37 Hz and 7–41 Hz). Feasibility was defined as the ability to obtain valid reproducible results. Prediction equations and 95% confidence intervals were derived for whole‐ and within‐breath Rrs and Xrs and for AX and Fres, using linear regression or Generalized Additive Models for Location, Scale and Shape. Results Of 306 children randomized, valid and reproducible results on ≥1 signal were obtained in 299 (98%) multiethnic (69% Caucasians: 8% Black: 23% Others) children aged 3–17 years, 91–189 cm tall. Standing height was the strongest predictor with no significant effect of sex, age, body mass index or ethnicity. Significant within‐patient differences were observed between Resmon Pro and tremoflo C‐100 measurements, justifying the derivation of device‐specific reference equations. Conclusion Valid reproducible oscillometry measurements are highly feasible in children aged 3 years and older. Device‐specific reference equations, valid for our multiethnic population, are derived.

Normal values of respiratory oscillometry in South African children and adolescents

“…The roughly inverse relationships between R rs and Ht exhibit some variability between the normative studies, and our data, which covers one of the widest Ht ranges, is consistent with this (see figure 2 ). We note that some nonlinear models, such as polynomial regressions, may predict unrealistic inflections in the R rs versus Ht relationships towards lower Ht [ 27 ] or higher Ht [ 26 ]. Apart from this, in the lowest Ht range (<120 cm), our 6-Hz R rs values are among the highest, together with lower-frequency (4 and 5 Hz) measurements expected to result in higher R rs [ 16 , 21 ], and that obtained with a special (head generator) device [ 25 ] leads to higher values than the uncorrected R rs .…”

“…Population differences in lung function such as anthropometric, sociocultural and environmental characteristics are well recognised [ 11 – 13 ]. Most oscillometry reference standards are specific for Caucasian populations from Europe, North America and Australia between the ages of 2 and 16 years [ 14 – 27 ]. Studies of non-Caucasian participants include Mexican, Thai, Emirati, Korean, Taiwanese, Turkish and Indian population groups with an age range between 3 and 17 years [ 28 – 34 ].…”

“…[11][12][13] Most oscillometry reference standards are specific for Caucasian populations from Europe, North America and Australia between the ages of 2 to 16 years. [14][15][16][17][18][19][20][21][22][23][24][25][26][27] Studies of non-Caucasian participants include Mexican, Thai, Emirati, Korean, Taiwanese, Turkish and Indian population groups with an age range between 3 and 17 years. [28][29][30][31][32][33][34] While reference equations derived from Caucasian data may be adequate for Caucasian South Africans, the most recent census describes the South African population as multi-ancestry: 80.7 % Black African, 8.8% mixed ancestry (which would include African ancestries, Asian, Caucasian, amongst others) and 2.6% Indian/Asian.…”

Validation of an outpatient questionnaire for bronchopulmonary dysplasia control

“…The only objective, standardized, measure of respiratory disease available is lung function measured by spirometry, which cannot be obtained until approximately 5–7 years of age and assumes cooperation with maximal effort maneuvers, which limits applicability in those with neurodevelopmental impairment 12 . Newer methods of obtaining lung function without sedation for children less than 6 years of age, such as oscillometry, 13 are being gradually employed, they are not currently widely available and lack well established reference values for a diverse population 14 . Respiratory disease symptom control has provided an essential tool in asthma clinical management and research.…”

Understanding the fundamentals of oscillometry from a strip of lung tissue

“…Oscillometry is practical because it is effortless and requires very little cooperation, making it easy to perform for both the subject and the operator. This also means that, in contrast to spirometry, it can be performed in a reliable fashion on infants and children (Gray et al, 2019;Lavizzari et al, 2021;Ducharme et al, 2022), as well as on patients who are very sick (i.e., weak) or afflicted by disabilities (Veldhoen et al, 2022;Vielkind et al, 2022) or other conditions where forced expiratory maneuvers are contraindicated (Jordon et al, 2022). Oscillometry is also useful for many reasons.…”