Methacholine challenge in young children as evaluated by spirometry and impulse oscillometry

Schulze, Johannes; Smith, Hans-Juergen; Fuchs, Johannes; Herrmann, Eva; Dreßler, Melanie; Rose, Markus A.; Zielen, Stefan

doi:10.1016/j.rmed.2012.01.007

Cited by 63 publications

(57 citation statements)

References 35 publications

(32 reference statements)

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“…48 Nos últimos anos, a atenção tem se voltado para o uso do IOS na avaliação da reatividade das vias aé-reas, em especial nas crianças asmáticas, com o objetivo de verificar a resposta broncodilatadora nesses pacientes. 12,37,41,[49][50][51][52][53][54] Nessa linha Marotta et al 12 verificaram a resposta ao broncodilatador em 73 crianças de 4 anos de idade propensas a serem asmáticas. Para tal, compararam os resultados obtidos através do IOS com dados espirométricos.…”

Section: Ios Em Pediatriaunclassified

Sistema de oscilometria de impulso em pediatria: revisão de literatura

Assumpção

Gonçalves

Ferreira

et al. 2014

Medicina (Ribeirão Preto)

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Introdução: a oscilometria de impulso (IOS) é considerado um método de avaliação da mecânica respiratória, e por ser não invasivo, vem sendo crescentemente indicado na assistência e investigação do paciente pediátrico. Estudos tem tido como interesse a determinação de valores de referência e a verificação da relação do IOS com outros métodos de avaliação respiratória. Objetivo: Apresentar uma atualização da literatura quanto ao sistema, critérios técnicos e interpretação de dados, bem como, a relação do sistema com outros métodos de avaliação respiratória e sua aplicabilidade clínica.Método: revisão bibliográfica com consulta nas bases de dados MEDLINE/PubMed e Ebsco, utilizando as palavras-chaves: “impulse oscillometry”, “reference values” e “child”. Considerou-se todo material com informações sobre o equipamento, suas indicações e aplicação como instrumento de avaliação em diferentes situações clínicas.Resultados: foram identificados 45 documentos, sendo 41 ensaios clínicos e 4 revisões, complementados com 20 trabalhos: 1 guideline, 1 manual sobre o equipamento e 18 artigos referentes ao tema. Esse material foi caracterizado por abordar o equipamento, seus parâmetros de avaliação, técnica de execução e posicionamento do paciente durante o exame, critérios de aceitabilidade e reprodutibilidade e interpretação dos dados obtidos. São várias as publicações dessa ferramenta na avaliação da mecânica respiratória de disfunções como asma e fibrose cística e geração de valores de referência em crianças saudáveis.Conclusão: o IOS é um recurso relativamente novo, cuja indicação em pediatriatem sido crescente, mas que ainda carece investigações, tanto técnicas quanto clínicas.

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Section: Ios Em Pediatriaunclassified

Sistema de oscilometria de impulso em pediatria: revisão de literatura

Assumpção

Gonçalves

Ferreira

et al. 2014

Medicina (Ribeirão Preto)

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“…The impulse oscillation system (IOS) is a simple, noninvasive method requiring only passive patient cooperation and may be useful in testing patients who cannot perform acceptable spirometry maneuvers [7,8]. IOS allows for the evaluation of lung function through the measurement of both airway resistance (Rrs) and airway reactance (Xrs) [9,10].…”

Section: Introductionmentioning

confidence: 99%

Impulse Oscillometry as a Predictor of Asthma Exacerbations in Young Children

et al. 2016

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Background: In a post-hoc analysis of a pediatric asthma study, we identified the predictors of asthma exacerbations (AEs) and related them to forced expiratory volume (FEV₁), the FEV₁/FVC ratio, and bronchial hyperresponsiveness (BHR). Objectives: We sought to detect predictors of AEs in a prospective study that utilizes impulse oscillometry (IOS) and to compare the results to previously determined predictors. Methods: A moderate AE was defined as an increased use of salbutamol during coughing episodes. Pulmonary function and BHR were measured during symptom- and medication-free periods. Additionally, allergen testing and IOS were included. To calculate the sensitivity and specificity of AE detection, a receiver-operating characteristic (ROC) curve was plotted, and accuracy was measured with the area under the ROC curve (AUC). A logistic regression analysis was used to predict the probability of an exacerbation. Results: Seventy-five pediatric patients (4-7 years of age) with intermittent asthma were included. In 69 patients, the following cut-off values demonstrated the best sensitivity and specificity combination for predicting an AE: FEV₁ 103.2% (AUC 0.62), BHR (PD₂₀methacholine) 0.13 mg (AUC 0.61), and, in 54 children, Rrs5 0.78 kPa × l^-1 × s (AUC 0.80). Logistic regression analysis demonstrated that the combination of all parameters predicted the individual risk of AEs with an accuracy of 86%. Conclusions: IOS, a simple method, predicted the probability of AEs in young children. Airway resistance, measured by IOS, was superior to FEV₁ and methacholine testing. The current data suggest that peripheral airway obstruction is present during symptom-free periods and that these children more likely experience AEs.

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“…2 However, changes in IOS parameters are well correlated with those in FEV 1 in many studies. 7,14,23 As shown in our previous studies, we investigated which IOS parameter is more correlated with BHR and found that reactance better reflects BHR than resistance. We do not have clear explanation for this finding.…”

Section: Discussionmentioning

confidence: 81%

“…13 Accordingly, studies using the oscillation technique to assess bronchial hyperresponsiveness in preschool children are increasing. 8,14,15 Clinical use of methacholine provocation testing with five sequential concentration is limited in young children due to difficulty of performing the challenge test correctly and the lack of criteria for positive test in differentiating the asthmatic children.…”

Section: Asian Pac J Allergy Immunol Doi 1012932/ap-290617-0108mentioning

confidence: 99%

Early detection of airway obstruction by impulse oscillometry system in methacholine challenge testing in preschool children

Yoon

Sheen

et al. 2018

Asian Pac J Allergy Immunol

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Background: Small airway hyperresponsiveness is a critical aspect in preschool children with asthmatic symptoms in terms of asthma control. The aim of this study was to elucidate the relationship of changes in reactance (Xrs) and resistance (Rrs) of IOS and FEV 1 with those in clinical parameters and to determine which IOS parameter is correlated with bronchial hyperresponsiveness before positive clinical endpoints.

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Methacholine challenge in young children as evaluated by spirometry and impulse oscillometry

Abstract: A short protocol for methacholine challenge testing is feasible in young children. IOS detected 70-80% of patients who responded in spirometry. During the challenge, the Rrs5 response preceded the FEV(1) response.

Cited by 63 publications

References 35 publications

Sistema de oscilometria de impulso em pediatria: revisão de literatura

Sistema de oscilometria de impulso em pediatria: revisão de literatura

Impulse Oscillometry as a Predictor of Asthma Exacerbations in Young Children

Early detection of airway obstruction by impulse oscillometry system in methacholine challenge testing in preschool children

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