Comparison of Spirometry and Impulse Oscillometry in Thai Childhood Asthma
Main Article Content
Abstract
Background: Impulse oscillometry (IOS), a new respiratory impedance measurement, is increasing in its popularity as a means to assess airway resistance in young children. Its great advantage lies in its effortless and fast performance, making the airway obstruction measurement easier for patients who are not able to perform spirometry tests. However, studies comparing spirometry with IOS in Thai children are rare.
Aims: To evaluate the correlation between IOS and spirometry parameters in Thai childhood asthma
Methods: Vyntus IOS (JEAGER®, Germany) and spirometry tests (Vyntus SPIRO) were performed in 48 children, aged 5-15 years old, who fulfilled the GINA asthma criteria. The study, approved by the hospital’s ethics committee, was conducted between March 1, 2020 and March 31, 2021 at the Queen Sirikit National Institute of Child Health, Thailand. (TCTR20220527005)
Results: Forty-eight childhood asthma patients with a median age of 10.79 (IQR = 8.41, 11.87) years underwent both IOS and spirometry measurements. Male sex was predominant (64.58%), and 77% of patients had well-controlled asthma (C-ACT score ≥20). In our study population, the atopic comorbidities were allergic rhinitis (91.67%), atopic dermatitis (10.42%) and food allergy (10.42%). Moreover, parental asthma was found in 16.67% of the participants. In comparison with spirometry, the percentage change of FEF25-75% was significantly negatively correlated with R5, R10, AX, and mean R5-R20 (r = -0.608, -0.528, -0.500, -0.511, respectively; p <0.001). Likewise, FEV1 was significantly negatively correlated with R15 and R20 (r = -0.520, -0.565, respectively; p <0.001). The linear regression prediction model demonstrated that a 30% increase in FEF25-75% was related to a 22.7% reduction in R5 (p = 0.007).
Conclusion: The percentage change of FEF25-75% was found to negatively correlate in statistically significant terms with R5 in Thai childhood asthma. Hence, IOS is an effective and feasible replacement for spirometry as a measurement modality of lung function, especially in young children.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Cottini M, Lombardi C, Berti A, Comberiati P. Small-airway dysfunction in paediatric asthma. Curr Opin Allergy Clin Immunol. 2021;21(2):128-134. doi:10.1097/ACI.0000000000000728
3. Knihtilä H, Kotaniemi-Syrjänen A, Pelkonen AS, Mäkelä MJ, Malmberg LP. Small airway function in children with mild to moderate asthmatic symptoms. Ann Allergy, Asthma Immunol. 2018;121(4):451-457. doi:10.1016/j.anai.2018.07.026
4. Francisco B, Ner Z, Ge B, Hewett J, König P, Kö nig P. Sensitivity of different spirometric tests for detecting airway obstruction in childhood asthma. J Asthma. 2015;52(5):505-511. doi:10.3109/02770903.2014.984842
5. Lebecque P, Kiakulanda P, Coates AL. Spirometry in the asthmatic child: Is FEF25–75 a more sensitive test than FEV1/FVC? Pediatr Pulmonol. 1993;16(1):19-22. doi:10.1002/ppul.1950160105
6. Knox-Brown B, Mulhern O, Feary J, Amaral AFS. Spirometry parameters used to define small airways obstruction in population-based studies: systematic review. Respir Res. 2020;23:67. doi:10.1186/s12931-022-01990-2
7. Kalliola S, Pekka Malmberg ; L, Kajosaari M, Mattila PS, Pelkonen AS, Mäkelä MJ. Assessing direct and indirect airway hyperresponsiveness in children using impulse oscillometry. doi:10.1016/j.anai.2014.04.026
8. Dubois AB, Botelho SY, Comroe JH. A new method for measuring airway resistance in man using a body plethysmograph: values in normal subjects and in patients with respiratory disease. J Clin Invest. 1956;35(3):327-335. doi:10.1172/JCI103282
9. Marotta A, Klinnert MD, Price MR, Larsen GL, Liu AH. Impulse oscillometry provides an effective measure of lung dysfunction in 4-year-old children at risk for persistent asthma. J Allergy Clin Immunol. 2003;112(2):317-322. doi:10.1067/mai.2003.1627
10. Bickel S, Popler J, Lesnick B, Eid N. Impulse oscillometry: Interpretation and practical applications. Chest. 2014;146(3):841-847. doi:10.1378/chest.13-1875
11. de Oliveira JPP, de Lima JHP, Chong ESDC, Medeiros D, Solé D, Wandalsen GF. Impulse oscillometry in the assessment of children’s lung function. Allergol Immunopathol (Madr). 2019;47(3):295-302. doi:10.1016/j.aller.2018.03.003
12. Brashier B, Salvi S. Measuring lung function using sound waves: Role of the forced oscillation technique and impulse oscillometry system. Breathe. 2015;11(1):57-65. doi:10.1183/20734735.020514
13. Desiraju K, Agrawal A. Impulse oscillometry: The state-of-art for lung function testing. Lung India. 2016;33(4):410-416. doi:10.4103/0970-2113.184875
14. Goldman MD, Saadeh C, Ross D. Clinical applications of forced oscillation to assess peripheral airway function. Respir Physiol Neurobiol. 2005;148(1-2 SPEC. ISS.):179-194. doi:10.1016/j.resp.2005.05.026
15. 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;118(6):664-671. doi:10.1016/j.anai.2017.04.009
16. Garg V, Parakh A. Spirometry vs Impulse oscillometry in evaluation of children with asthma. Published online 2020:2647. doi:10.1183/13993003.congress-2020.2647
17. Bailly C, Crenesse D, Albertini M. Evaluation of impulse oscillometry during bronchial challenge testing in children. Pediatr Pulmonol. 2011;46(12):1209-1214. doi:10.1002/ppul.21492
18. Shi Y, Aledia AS, Tatavoosian A V., Vijayalakshmi S, Galant SP, George SC. Relating small airways to asthma control by using impulse oscillometry in children. J Allergy Clin Immunol. 2012;129(3):671-678. doi:10.1016/j.jaci.2011.11.002
19. Batmaz SB, Kuyucu S, Arikoglu T, Tezol O, Aydogdu A. Impulse oscillometry in acute and stable asthmatic children: A comparison with spirometry. J Asthma. 2016;53(2):179-186. doi:10.3109/02770903.2015.1081699
20. Kreetapirom P, Kiewngam P, Jotikasthira W, Kamchaisatian W, Benjaponpitak S, Manuyakorn W. Forced oscillation technique as a predictor for loss of control in asthmatic children. Asia Pac Allergy. 2020;10(1):1-8. doi:10.5415/apallergy.2020.10.e3
21. Zeng J, Chen Z, Hu Y, Hu Q, Zhong S, Liao W. Asthma control in preschool children with small airway function as measured by IOS and fractional exhaled nitric oxide. Respir Med. 2018;145:8-13. doi:10.1016/j.rmed.2018.10.009
22. Kalliola S, Malmberg LP, Pelkonen AS, Mäkelä MJ. Aberrant small airways function relates to asthma severity in young children. Respir Med. 2016;111:16-20. doi:10.1016/j.rmed.2015.12.006
23. Lipworth BJ. Small airway dysfunction is associated with poorer asthma control. Eur Respir J. 2014;44(5):1353-1355. doi:10.1183/09031936.00082314
24. Komarow HD, Skinner J, Young M, et al. A Study of the Use of Impulse Oscillometry in the Evaluation of Children With Asthma: Analysis of Lung Parameters, Order Effect, and Utility Compared With Spirometry. Pediatr Pulmonol. 2012;47:18-26. doi:10.1002/ppul.21507
25. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948-968. doi:10.1183/09031936.05.00035205
26. Song TW, Kim KEW, Kim ES, Kim KEW, Sohn MH. Correlation between spirometry and impulse oscillometry in children with asthma. Acta Paediatr Int J Paediatr. 2008;97(1):51-54. doi:10.1111/j.1651-2227.2007.00526.x
27. King GG, Bates J, Berger KI, et al. Technical standards for respiratory oscillometry. Eur Respir J. 2020;55(2):1-21. doi:10.1183/13993003.00753-2019
28. Burman J, Malmberg LP, Remes S, Jartti T, Pelkonen AS, Mäkelä MJ. Impulse oscillometry and free-running tests for diagnosing asthma and monitoring lung function in young children. Ann Allergy, Asthma Immunol. 2021;127(3):326-333. doi:10.1016/j.anai.2021.03.030