The Usefulness of the Forced Oscillation Technique in the Diagnosis of Bronchial Asthma in Children

Abstract

The forced oscillation technique (FOT) requires minimal patient cooperation and is useful for children. However, comprehensive values of respiratory impedance at baseline and after the reversibility test have not been definitively confirmed. The aim of this study was to evaluate the basic parameters of FOT reactance (Xrs) and resistance (Rrs) in groups of healthy children and children with controlled and uncontrolled asthma. The second aim was the assessment of the reversibility bronchial test using the forced oscillation method in children with bronchial asthma. Materials and Methods. One hundred and six children aged from 2 to 6 years diagnosed with early-onset controlled or uncontrolled asthma and healthy controls were included in this single-center, prospective, randomized study. All asthmatic patients and healthy controls underwent basic FOT as one measurement according to the recommendation of Resmon Pro FOT. The reversibility test was then performed 15 min after the administration of 200 mcg salbutamol by MDI in all patients. Results. Basic Rrs showed significantly higher mean values in patients with uncontrolled asthma compared to patients with controlled asthma, which were in turn higher than the values for patients in the control group (11.14 ± 1.29 versus 15.71 ± 2.6 versus 9.21 ± 0.98, resp.; p < 0.05). The data analysis showed similar relationships in terms of the Xrs between the studied groups (−4.76 ± 1.19 versus −7.31 ± 2.33 versus −2.11 ± 0.48, resp.; p < 0.05). According to the changes in the Rrs values, 35 (66%) positive bronchial reversibility tests were obtained in 53 subjects with controlled asthma and in 39 (74%) subjects with uncontrolled asthma. Conclusions. Rrs and Xrs obtained by FOT well-discriminate patients with asthma from healthy children. A bronchial reversibility test involving the use of FOT is valuable for the diagnosis of bronchial asthma.

Physiological tests of small airways function in diagnosing asthma: a systematic review

“…19 Oscillometry has been suggested as a useful tool in diagnosing asthma in children. 34 However, there remains a lack of universal reference ranges, especially in adults. Height 23 and sex 35 conducted a multicentre study on healthy subjects in an effort to produce reference ranges for oscillometry in adults, but only one ethnicity was studied.…”

Técnica De Oscilações Forçadas Na Avaliação E Manejo De Crianças Asmáticas: Uma Revisão Narrativa

“…Este método de avaliação contempla propriedades resistivas e elásticas do sistema respiratório. (5,7,13,15,17) Os estudos que utilizaram avaliação multifrequencial e representam a maior parte dos trabalhos analisados (71%), esse tipo de análise pode ser caracterizada com lenta, uma vez que representa a média do comportamento do sistema respiratório ao longo de vários ciclos ventilatórios, gerando resultados mais detalhados. Os índices obtidos a partir desta análise contemplam R rs e X rs em várias frequências, permitindo avaliação de índices associados à resistência total, não homogeneidade e complacência dinâmica do sistema respiratório.…”

“…(1,10,19) A R rs e a X rs são marcadores indiretos de obstrução bronquial e tem boa sensibilidade para avaliar vias aéreas periféricas. (12,17) A redução da resistência após a inalação de broncodilatador tem boa sensibilidade e excelente especificidade para asma em crianças. (11,21) FOT E ESPIROMETRIA NA ASMA O teste de espirometria é o mais utilizado na avaliação de distúrbios obstrutivos das vias aéreas, entretanto, apresenta restrições em faixas etárias inferiores a seis anos, ainda que a American Thoracic Society (ATS) e European Respiratory Society (ERS) tenham estabelecido critérios de aceitabilidade e reprodutibilidade mais flexíveis para esse grupo.…”

Difficult and Severe Asthma in Children

“…Xrs measures the elastic recoil forces of the respiratory system and determines the effective ventilation of the lung’s peripheral areas. Although the scientific literature is conflicting, these parameters appear to be an important tool for the assessment of bronchial asthma in children [ 16 ].…”