Impulse Oscillometry's Function in Measuring Children's Asthma Control a Research Study
Main Article Content
Background: Around the world, asthma affects children and is a common chronic respiratory condition. For the disease to be managed effectively, an accurate assessment of asthma control is essential. A non-invasive method called "Impulse Oscillometry (IOS)" has become more popular for evaluating the respiratory function in asthmatic kids. This study's goal was to assess IOS's contribution to determining children's asthma control.
Methods: For this cross-sectional study, 100 kids with an asthma diagnosis who were between the ages of 5 and 16 were enrolled. Each participant had lung function testing with the IOS and had their demographic and clinical information gathered. The "Asthma Control Test (ACT)" was used to evaluate asthma control. The IOS parameters were examined and contrasted across various asthma control levels.
Results: There were 42 girls and 58 boys in the study population, with a mean age of 9.7 3.5 years. The majority of children (60%) had uncontrolled asthma, which was followed by asthma that was only moderately (24%) and fully (16%) controlled. IOS metrics including resonant frequency (Fres), reactance at 5 Hz (X5), and resistance at 5 Hz (R5) were discovered to substantially differ amongst the various asthma control levels (p 0.05). When compared to asthma that was under control, the R5 value was higher in uncontrolled asthma (p <0.001). When compared to asthma that was under control, X5 and Fres were lower in uncontrolled asthma (p <0.001).
Conclusion: As a result of this study, it is possible to evaluate a child's asthma control using IOS parameters. The levels of asthma control were observed to considerably differ in R5, X5, and Fres. Clinicians may find IOS to be a helpful tool in managing children's asthma.
Global Initiative for Asthma. Global strategy for asthma management and prevention, 2020. Available from: https://ginasthma.org/gina-reports/
Reddel HK, Bateman ED, Becker A, et al. A summary of the new GINA strategy: a roadmap to asthma control. Eur Respir J. 2015;46(3):622-639.
Busse WW, Lemanske RF Jr, Gern JE. The role of viral respiratory infections in asthma and asthma exacerbations. Lancet. 2010;376(9743):826-834.
Haahtela T, Tamminen K, Kava T, et al. Thirteen-year follow-up of patients with asthma and mould sensitivity. Eur Respir J. 1994;7(2):209-214.
Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med. 2012;18(5):716-725.
Oostveen E, MacLeod D, Lorino H, et al. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J. 2003;22(6):1026-1041.
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 Jul 1;175(1):130-47. doi: 10.1164/rccm.200605-642ST. PMID: 17138816.
Aurora P, Stocks J, Oliver C, et al. Quality control for spirometry in preschool children with and without lung disease. Am J Respir Crit Care Med. 2004;169(10):1152-1159.
Ranganathan SC, Stocks J, Dezateux C. The evolution of modern respiratory medicine: innovations in paediatric lung function testing. Arch Dis Child. 2015;100(5):470-476.
Niimi A, Matsumoto H, Takemura M, Ueda T, Chin K, Mishima M. Relationship of airway wall thickness to airway sensitivity and airway reactivity in asthma. Am J Respir Crit Care Med. 2003;168(8):983-988. doi:10.1164/rccm.200211-1268OC.
Galant SP, Komarow HD, Shin HW, Siddiqui S, Lipworth BJ. The case for impulse oscillometry in the management of asthma in children and adults. Ann Allergy Asthma Immunol. 2017 Jun;118(6):664-671. doi: 10.1016/j.anai.2017.04.009. PMID: 28583260; PMCID: PMC5486406..
Angrill J, Agusti C, de Celis R, et al. Bronchial inflammation and colonization in patients with clinically stable bronchiectasis. Am J Respir Crit Care Med. 2001;164(9):1628-1632.
Brusasco V, Crimi E, Barisione G, Spanevello A, Rodarte JR, Pellegrino R. Airway responsiveness to methacholine: effects of deep inhalations and airway inflammation. J Appl Physiol (1985). 1999 Aug;87(2):567-73. doi: 10.1152/jappl.19126.96.36.1997. PMID: 10444614..
van Grunsven PM, van Schayck CP, Molema J, Akkermans RP, van Weel C. Effect of inhaled corticosteroids on bronchial responsiveness in patients with "corticosteroid naive" mild asthma: a meta-analysis. Thorax. 1999 Apr;54(4):316-22. doi: 10.1136/thx.54.4.316. PMID: 10092692; PMCID: PMC1745461..
Sterk PJ, Fabbri LM, Quanjer PH, et al. Airway responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993;16:53-83.
Zeki AA, Schivo M, Chan A, Albertson TE, Louie S. The Asthma-COPD Overlap Syndrome: A Common Clinical Problem in the Elderly. J Allergy (Cairo). 2011;2011:861926. doi:10.1155/2011/861926
Saglani S, Malmstrom K, Pelkonen AS, Malmberg LP, Lindahl H, Kajosaari M, et al. Airway remodeling and inflammation in symptomatic infants with reversible airflow obstruction. Am J Respir Crit Care Med. 2005 Jul 15;171(12):722-7. doi: 10.1164/rccm.200406-806OC. PMID: 15764727.
Mandilwar S, Thorve SM, Gupta V, Prabhudesai P. Role of impulse oscillometry in diagnosis and follow-up in bronchial asthma. Lung India. 2023;40(1):24-32. doi:10.4103/lungindia.lungindia_251_22.
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 Oct;132(4):854-61.e1. doi: 10.1016/j.jaci.2013.04.022. Epub 2013 May 31. PMID: 23726539.
Dellaca' RL, Santus P, Aliverti A, Stevenson N, Centanni S, Macklem PT, et al. Detection of expiratory flow limitation in COPD using the forced oscillation technique. Eur Respir J. 2004 Apr;23(4):232-40. doi: 10.1183/09031936.04.00102004. PMID: 15083757.
Kim YH, Park HB, Kim MJ, et al. Fractional exhaled nitric oxide and impulse oscillometry in children with allergic rhinitis. Allergy Asthma Immunol Res. 2014;6(1):27-32. doi:10.4168/aair.2014.6.1.27