Forced Oscillation Technique for Monitoring the Respiratory Status of Children with Cystic Fibrosis: A Systematic Review

Abstract

Spirometry is considered the gold standard method for monitoring lung function of patients with cystic fibrosis (CF) but it requires patients’ cooperation and therefore it is not useful for the majority of preschool-aged children. Oscillometry is an alternative modality for lung function monitoring that requires minimal cooperation and can be applied in children as young as 3 years of age. Furthermore, it generates lesser aerosol compared to spirometry, an issue that is of considerable importance in the COVID-19 era. The aim of this review was to present the existing clinical data regarding the application of oscillometry in children and adolescents with CF. The method seems to have acceptable feasibility and repeatability. However, there is conflicting data regarding the correlation of oscillometry values with the clinical symptoms of CF patients either in clinically stable or in exacerbation periods. Furthermore, it is not clear to what extent oscillometry measurements correlate with the spirometry indices. Based on current evidence, spirometry cannot be substituted by oscillometry in the monitoring of the respiratory status of children and adolescents with CF.

What Is Most Suitable for Children With Cystic Fibrosis—The Relationship Between Spirometry, Oscillometry, and Multiple Breath Nitrogen Washout

“…It has also been shown that spirometry may not be very sensitive in detecting mild to moderate lung damage in children with CF (5). What is more, during spirometry, a quite large amount of aerosol is generated, which is essential in the coronavirus disease 2019 era (6). Hence, there is a need for a lung function test that is sensitive enough to pick up early abnormalities and that can also be performed easily in preschool children and children with advanced bronchopulmonary disease, who are unable to perform spirometry (4).…”

“…It reflects the elasticity of the lung and is negative in sign. Other important parameters in IOS are frequency at which the reactance crosses zero is called resonant frequency (Fres) and AX, which represents the sum of all reactance components at all frequencies before the resonant frequency (6,9). IOS can differentiate between small and large airway obstruction and is more sensitive than spirometry for peripheral airway disease.…”

“…However, pulmonary function testing in children remains problematic.Objectives: Our study aimed to correlate the results of impulse oscillometry (IOS) with those of multiple breath nitrogen washout (MBNW) in our pediatric CF population. We also compared those parameters between the groups with and without spirometric features of obturation.Methods: We collected 150 pulmonary function test sets, including spirometry, IOS, and MBNW in patients with CF aged 12.08 ± 3.85 years [6][7][8][9][10][11][12][13][14][15][16][17][18]. The study group was divided into two subgroups: IA (without obturation) and IB (with obturation).…”

“…Methods: We collected 150 pulmonary function test sets, including spirometry, IOS, and MBNW in patients with CF aged 12.08 ± 3.85 years [6][7][8][9][10][11][12][13][14][15][16][17][18]. The study group was divided into two subgroups: IA (without obturation) and IB (with obturation).…”

Sinus Disease Grading on Computed Tomography Before and After Modulating Therapy in Adult Patients with Cystic Fibrosis

“…Cystic fibrosis (CF) is a common autosomal recessive disorder, caused by cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations, with highest prevalence in Europe, North America and Australia, affecting about 1 in 2000–3000 Caucasian population newborns [ 1 2 ]. CF morbidity and mortality is mainly attributed to lung disease progression and respiratory exacerbations [ 3 ]. CFTR protein is not just a chloride channel and its disfunction is at the base of a multisystem disease [ 4 5 ].…”