Asthma control in preschool children with small airway function as measured by IOS and fractional exhaled nitric oxide

Abstract

This study investigated the accuracy of impulse oscillometry (IOS) combined with fractional exhaled nitric oxide (FeNO) to assess asthma control among preschool children. Methods: A total of 79 preschool children(3-6 year old) with asthma and 25 healthy preschool children who visited a paediatrician were enrolled in this study. All of the children were tested for allergens, respiratory system resistance (at 5 and 20 Hz [R5, R20]), respiratory system reactance (at 5 Hz [X5]), the resonant frequency of reactance (Fres), and the area under the reactance curve (between 5 Hz and Fres (reactance area [AX]) using IOS and FeNO. A paediatric respiratory specialist who was unaware of the IOS and FeNO results assigned children with asthma to either the asthma-controlled group (n = 27) or the asthma-uncontrolled group (n = 52) based on the Global Initiative for Asthma (GINA) criteria. A healthy control group (n = 25) was also included. The relationships between the FeNO and IOS values as well as the asthma control of the three groups were analysed, and the areas under the curve (AUCs) were calculated for each measure. Results: (1) During the controlled group, means ± standard deviations of AX,

Predicting asthma exacerbation by impulse oscillometry evaluation of small airway function and fractional exhaled nitric oxide in preschool children

“…However, no previous study has investigated the combination of IOS small airway function indicators and FeNO prediction of asthma attacks. In our previous study, FeNO combined with the small airway function parameter X5 accurately assessed asthma control among preschool children 22 . Here, we hypothesized that IOS indices of peripheral airway function and FeNO might predict future loss of asthma control in preschool children.…”

The predictive value of impulse oscillometry for asthma exacerbations in childhood: a systematic review and meta-analyses

“…The included five trials found that R5 increased in asthma exacerbations [14][15][16][17]19] . Only Smith et al did not report the difference in R5 between the two groups [17,19] . Our study showed that R5 had a good correlation with the acute attack of asthma.…”

“…1. A total of 6 eligible studies [15][16][17][18][19][20] , published between 2016 and 2020, were enrolled in the present meta-analysis. The studies were conducted in the following geographical regions:USA(n=2),Germany(n=1), Turkey(n=1), China(n=2).…”

“…The studies were conducted in the following geographical regions:USA(n=2),Germany(n=1), Turkey(n=1), China(n=2). All studies used well-controlled asthma as the control group, and 4 studies also added healthy people as the control group [15,17,18,20] . Our study focused on the role of IOS in predicting asthma exacerbations or loss of control, so we did not include healthy people.…”

Clinical Applications of Impulse Oscillometry

“…Even in patients who are 5 years old and older, the predicted FEV1 may not be as accurate as it is in adults. On the other hand, IOS is more feasible in terms of detecting small airway dysfunction [27,28]. Classically, small airway dysfunction is detected via the FEF 25/FEF 75.…”