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Impulse oscillometry bronchodilator response in preschool children
  • +5
  • Johannes Schulze,
  • A. Meoli,
  • Jordis Trischler,
  • M. Hutter,
  • Melanie Dressler,
  • Susanna Esposito,
  • K. Blümchen,
  • Stefan Zielen
Johannes Schulze
Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
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A. Meoli
Universita degli Studi di Parma Dipartimento di Medicina e Chirurgia

Corresponding Author:[email protected]

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Jordis Trischler
Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
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M. Hutter
Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
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Melanie Dressler
Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
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Susanna Esposito
Universita degli Studi di Parma Dipartimento di Medicina e Chirurgia
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K. Blümchen
Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
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Stefan Zielen
Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt
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Abstract

Background: In preschoolers, performing an acceptable spirometry and measuring bronchodilator response (BDR) is challenging; impulse oscillometry (IOS) may be an alternative to spirometry. However, there is still no consensus in standardization of BDR for IOS in young children. Objective: The objective of the study was to identify optimal thresholds to define a positive BDR test with IOS. Methods: Young infants aged 3 to 6 years with suspected asthma were evaluated in a real life setting with both IOS and spirometry pre- and post-BDR. The BDR was defined as positive when the change of FEV1 was ≥12% and/or ≥200 mL. Results: Among 72 patients (age 4.98 ± 0.94 years; 64% boys), 36 (age 5.15 ± 0.99 years; 64% boys) were selected for the subsequent analysis according to ATS / ERS quality criteria of measurements. The spirometric BDR was found positive in seven subjects (19.4%). In IOS, the mean decrease in R5 and AX was 19.86% ± 10.04 and 44% ± 22.10, and the mean increase in X5 was 23.28% ± 17.82, respectively. A decrease in R5 of 25.7% (AUC 0.77, p = 0.03) and an increase in X5 of 25.7% (AUC 0.75, p = 0.04) showed the best combination of sensitivity and specificity to detect an increase of FEV1 ≥12% and/or ≥200 mL. Conclusion: The IOS may present a valid alternative to spirometry to measure BDR in preschool children. We are considering a decrease of 26% in R5 and an increase of 26% in X5 as diagnostic threshold for BDR.
21 Feb 2023Submitted to Pediatric Pulmonology
21 Feb 2023Review(s) Completed, Editorial Evaluation Pending
21 Feb 2023Submission Checks Completed
21 Feb 2023Assigned to Editor
12 Mar 2023Reviewer(s) Assigned
24 Aug 2023Editorial Decision: Revise Major
21 Nov 20231st Revision Received
30 Jan 2024Review(s) Completed, Editorial Evaluation Pending