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Duenas-Meza E, Correa E, López E, Morales JC, Aguirre-Franco CE, Morantes-Ariza CF, Granados CE, González-García M. Impulse oscillometry reference values and bronchodilator response in three- to five-year old children living at high altitude. J Asthma Allergy 2019; 12:263-271. [PMID: 31571933 PMCID: PMC6757110 DOI: 10.2147/jaa.s214297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/05/2019] [Indexed: 12/14/2022] Open
Abstract
Introduction Impulse oscillometry (IOS) is used to measure airway impedance. It is an effective tool for diagnosing and treating respiratory diseases, and it has the advantage that it does not require forced respiratory maneuvers. IOS reference values are required for each population group. Objective This study aimed to determine the IOS reference values and bronchodilator response in healthy preschool children living in Bogotá, Colombia. Methods We performed a cross-sectional study in preschool children who had no history of respiratory disease; 96 children fit the parameters for testing to determine normal values according to the American Thoracic Society and European Respiratory Society criteria. Results Values for respiratory resistance (Rrs) and reactance (Xrs) at 5, 10, and 20 Hz, respiratory impedance (Zrs, and resonance frequency (Fres) were established. Height was the most influential independent variable for IOS values; an increase in height led to a reduction in Rrs5 and Rrs20 and an increase in Xrs5. After the administration of 400 mcg of salbutamol the values for Rrs5(−17.48%), Rrs20(−8.63%), Fres (−10.68%), and area of reactance (−35.44%) were reduced, meanwhile Xrs5 (15.35%) was increased. Conclusions Normal IOS values before and after the administration of 400 mcg of salbutamol were determined for a population of children aged 3–5 years at 2,640 m. Reference IOS equations for these children are presented. A relative change of up to −28% and 36% after the use of salbutamol for respiratory resistance and reactance, respectively, should be considered as an upper limit of the normal range, and possible appropriate cut-off values for defining significant response for evaluating therapeutic interventions.
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AlBlooshi A, AlKalbani A, Narchi H, Al-Hamad S, Al-Houqani M, AlBadi G, Souid AK, Hall GL. Respiratory function in healthy Emirati children using forced oscillations. Pediatr Pulmonol 2018. [PMID: 29528572 DOI: 10.1002/ppul.23985] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The forced oscillation technique (FOT) allows the quantification of respiratory function, does not require active cooperation and as such is ideally suited for use in young children. The application of the FOT in non-Caucasian populations is limited and it remains unclear if current reference ranges for the FOT in Caucasian children are appropriate for children in the Arabian Peninsula. This study explored the use of the FOT in healthy school-aged children in the United Arab Emirates (UAE). METHODS Lung function using FOT was assessed in healthy Emirati children aged 4-12 years. Using a validated questionnaires general medical and respiratory histories were obtained. Prediction equations for resistance (Rrs), reactance (Xrs), and area under reactance curve (AX) were calculated and compared to previous studies. RESULTS FOT was successfully obtained in 291 healthy Emirati children. Linear regression modelling including weight, height, age, and gender in transformed FOT outcomes demonstrated that height was the strongest predictor of FOT outcomes (P < 0.001). Using the equated prediction equation Z-scores were calculated. FOT outcomes in Emirati children did not match previously published reference equations in Caucasians children (P < 0.001). CONCLUSION FOT measurements were feasible in Emirati school-children. New FOT reference equation in Emirati children were derived. FOT reference equation in Emirati children was different from published equations in Caucasians.
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Affiliation(s)
- Afaf AlBlooshi
- Department of Pediatrics, United Arab Emirates University, Al-Ain, UAE
| | | | - Hassib Narchi
- Department of Pediatrics, United Arab Emirates University, Al-Ain, UAE
| | - Sania Al-Hamad
- Department of Pediatrics, United Arab Emirates University, Al-Ain, UAE
| | | | - Ghaya AlBadi
- Department of Pediatrics, United Arab Emirates University, Al-Ain, UAE
| | - Abdul-Kader Souid
- Department of Pediatrics, United Arab Emirates University, Al-Ain, UAE
| | - Graham L Hall
- Children's Lung Health, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University and Centre of Child Health Research, University of Western Australia, Perth, Australia
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Alblooshi A, Alkalbani A, Albadi G, Narchi H, Hall G. Is forced oscillation technique the next respiratory function test of choice in childhood asthma. World J Methodol 2017; 7:129-138. [PMID: 29354485 PMCID: PMC5746666 DOI: 10.5662/wjm.v7.i4.129] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 10/08/2017] [Accepted: 11/02/2017] [Indexed: 02/06/2023] Open
Abstract
Respiratory diseases, especially asthma, are common in children. While spirometry contributes to asthma diagnosis and management in older children, it has a limited role in younger children whom are often unable to perform forced expiratory manoeuvre. The development of novel diagnostic methods which require minimal effort, such as forced oscillation technique (FOT) is, therefore, a welcome and promising addition. FOT involves applying external, small amplitude oscillations to the respiratory system during tidal breathing. Therefore, it requires minimal effort and cooperation. The FOT has the potential to facilitate asthma diagnosis and management in pre-school children by faciliting the objective measurement of baseline lung function and airway reactivity in children unable to successfully perform spirometry. Traditionally the use of FOT was limited to specialised centres. However, the availability of commercial equipment resulted in its use both in research and in clinical practice. In this article, we review the available literature on the use of FOT in childhood asthma. The technical aspects of FOT are described followed by a discussion of its practical aspects in the clinical field including the measurement of baseline lung function and associated reference ranges, bronchodilator responsiveness and bronchial hyper-responsiveness. We also highlight the difficulties and limitations that might be encountered and future research directions.
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Affiliation(s)
- Afaf Alblooshi
- Department of Pediatrics, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Alia Alkalbani
- Department of Pediatrics, Tawam Hospital, Al-Ain, United Arab Emirates
| | - Ghaya Albadi
- Department of Pediatrics, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Hassib Narchi
- Department of Pediatrics, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Graham Hall
- Department of Children’s Lung Health, Telethon Kids Institute, Perth 6000, Australia
- School of Physiotherapy and Exercise Science, Curtin University and Centre of Child Health Research, University of Western Australia, Perth 6000, Australia
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Yon DK, Jee HM, Ha EK, Lee SJ, Jung YH, Lee KS, Han MY. Small airway bronchodilator response to different doses of salbutamol in 7-year-old children. Respir Res 2017; 18:148. [PMID: 28774310 PMCID: PMC5543428 DOI: 10.1186/s12931-017-0632-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/26/2017] [Indexed: 11/10/2022] Open
Abstract
The Global Initiative for Asthma (GINA) guidelines do not specify a bronchodilator range for bronchodilator response (BDR) testing and simply recommend a salbutamol dose of 200 to 400 μg. We determined the oscillometric BDR results of children given low-dose (2 puffs, 200 μg) and standard-dose (4 puffs, 400 μg) salbutamol to compare the small airway responses of healthy controls (defined using criteria based on the guidelines developed at the American Thoracic Society) and exclusion subjects (defined as any child that did not meet the inclusion criteria for healthy controls). The oscillometric reactance of small airways is significantly associated with the dose of salbutamol used for BDR testing in exclusion children. We suggest use of the standard-dose of salbutamol for oscillometric BDR testing.
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Affiliation(s)
- Dong Keon Yon
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Eun Kyo Ha
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Seung Jin Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Young-Ho Jung
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Kyung Suk Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
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Le Tuan T, Nguyen NM, Demoulin B, Bonabel C, Nguyen-Thi PL, Ioan I, Schweitzer C, Nguyen HTT, Varechova S, Marchal F. Specific airway resistance in healthy young Vietnamese and Caucasian adults. Respir Physiol Neurobiol 2015; 211:17-21. [PMID: 25796614 DOI: 10.1016/j.resp.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 02/25/2015] [Accepted: 03/02/2015] [Indexed: 11/28/2022]
Abstract
In healthy Vietnamese children the respiratory resistance has been suggested to be similar at 110 cm height but larger at 130 cm when compared with data in Caucasians from the literature, suggesting smaller airways in older Vietnamese children (Vu et al., 2008). The hypothesis tested here is whether the difference in airway resistance remains consistent throughout growth, and if it is larger in adult Vietnamese than in Caucasians. Airway resistance and Functional Residual Capacity were measured in healthy young Caucasian and Vietnamese adults in their respective native country using identical equipment and protocols. Ninety five subjects in Vietnam (60 males) and 101 in France (41 males) were recruited. Airway resistance was significantly larger in Vietnamese than in Caucasians and in females than in males, consistent with difference in body dimensions. Specific airway resistance however was not different by ethnicity or gender. The findings do not support the hypothesis that airway size at adult age - once normalized for lung volume - differs between Vietnamese and Caucasians.
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Affiliation(s)
- Thanh Le Tuan
- Department of Physiology, Hanoi Medical University , Hanoi, Vietnam
| | - Ngoc Minh Nguyen
- Department of Physiology, Hanoi Medical University , Hanoi, Vietnam
| | - Bruno Demoulin
- Department of Physiology, University of Lorraine, Vandoeuvre les Nancy, France
| | - Claude Bonabel
- Department of Paediatric Lung Function Testing, University Hospital of Nancy, Children's Hospital, Vandoeuvre les Nancy, France
| | - Phi Linh Nguyen-Thi
- Department of Epidemiology, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Iulia Ioan
- Department of Paediatric Lung Function Testing, University Hospital of Nancy, Children's Hospital, Vandoeuvre les Nancy, France
| | - Cyril Schweitzer
- Department of Paediatric Lung Function Testing, University Hospital of Nancy, Children's Hospital, Vandoeuvre les Nancy, France; Department of Epidemiology, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - H T T Nguyen
- Department of Physiology, Hanoi Medical University , Hanoi, Vietnam
| | - Silvia Varechova
- Department of Paediatric Lung Function Testing, University Hospital of Nancy, Children's Hospital, Vandoeuvre les Nancy, France; Department of Epidemiology, University Hospital of Nancy, Vandoeuvre les Nancy, France
| | - Francois Marchal
- Department of Paediatric Lung Function Testing, University Hospital of Nancy, Children's Hospital, Vandoeuvre les Nancy, France; Department of Epidemiology, University Hospital of Nancy, Vandoeuvre les Nancy, France.
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Vu LTT, Demoulin B, Nguyen MTH, Nguyen YT, Marchal F. Respiratory impedance and response to salbutamol in asthmatic Vietnamese children. Pediatr Pulmonol 2010; 45:380-6. [PMID: 20306537 DOI: 10.1002/ppul.21201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There is a high incidence of pediatric asthma in Vietnam, but little lung function data are available. The aim of the study was to compare respiratory resistance (Rrs), reactance (Xrs), and responses to salbutamol between asthmatic and healthy primary school children in Hanoi. Because respiratory mechanics vary along the breathing cycle, measurements were assessed separately in inspiration (Rrsi, Xrsi) and expiration (Rrse, Xrse).Inpatients with doctor-diagnosed asthma were measured 2-3 days following admission using the forced oscillation technique (FOT) at a single frequency (8 Hz). Z-scores and responses to salbutamol were compared between 102 asthmatics and 98 controls, and accuracy of group classification by FOT parameters was assessed by Youden index, an indicator to the proportion of subjects correctly classified in each group.In asthmatics versus controls, Rrsi-but not Rrse-was significantly larger and both Xrsi and Xrse were significantly more negative (P < 0.01). Both Rrs and Xrs responses to salbutamol were significantly larger in asthmatics than controls (P < 0.001). Youden indexes indicated response to salbutamol generally had better diagnostic values than Z-scores and was best discriminative first with Rrsi, then with Xrse.It is concluded that different FOT characteristics may be described in asthmatic and healthy Vietnamese children. The diagnostic value of each parameter depends upon the breathing cycle. Most useful in practice probably is the response to salbutamol measured by Rrsi.
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Affiliation(s)
- Lan T T Vu
- Department of Pediatric Pulmonology, Saint Paul Hospital (Khoa ho hap nhi Xanh pon), Hanoi, Vietnam
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