Comparative analysis of the bronchodilator response measured by impulse oscillometry (IOS), spirometry and body plethysmography in asthmatic children.

BACKGROUND Asthma is common among young children. The assessment of respiratory resistance by the impulse oscillometry system (IOS), based on the superimposition of respiratory flow by short-time impulses, requires no patient active collaboration. AIM We evaluated the baseline repeatability and bronchodilator response of IOS indices in preschool children, their correlation with spirometry and whole body plethysmography, and differences between atopic and nonatopic children. PATIENTS AND METHODS Thirty-three asthmatic children (3-6 yrs.) underwent IOS measurement (R5rs, R20rs and X5rs) by triplicate at the baseline, after placebo and after salbutamol inhalation. Spirometry (FEV1) and whole body plethysmography (sRaw) were made at the baseline and after salbutamol. Baseline within-test (coefficient of variation: CV%) and between-test repeatability (baseline-placebo) were addressed. Bronchodilator response was evaluated by the SD index (change in multiples of the between-test repeatability). RESULTS Baseline repeatability for R5rs was 4.1%. Its values decreased by 2SD after salbutamol inhalation, and correlated with FEV1 and sRaw at both, baseline (r=-0.51 and r=0.49) and post-salbutamol (r=-0.63 and r=0.54). A trend towards correlation between salbutamol-induced changes in R5rs and in sRaw (r=0.33) was observed. Atopic and non-atopic children showed no differences in lung function. CONCLUSION IOS was well accepted by young asthmatic children and provided reproducible and sensitive indices of lung function. Resistance values obtained by IOS at low frequency (R5rs) were reproducible and correlated with spirometry and plethysmographic values.