Tidal changes in respiratory resistance are sensitive indicators of airway obstruction in children

Czovek, Dorottya, Shackleton, Claire, Hantos, Zoltán, Taylor, Kate, Kumar, Anushma, Chacko, Archana, Ware, Robert S., Makan, Gergely, Radics, Bence, Gingl, Zoltán and Sly, Peter D. (2016) Tidal changes in respiratory resistance are sensitive indicators of airway obstruction in children. Thorax, 71 10: 907-915. doi:10.1136/thoraxjnl-2015-208182


Author Czovek, Dorottya
Shackleton, Claire
Hantos, Zoltán
Taylor, Kate
Kumar, Anushma
Chacko, Archana
Ware, Robert S.
Makan, Gergely
Radics, Bence
Gingl, Zoltán
Sly, Peter D.
Title Tidal changes in respiratory resistance are sensitive indicators of airway obstruction in children
Journal name Thorax   Check publisher's open access policy
ISSN 1468-3296
0040-6376
Publication date 2016-05-13
Sub-type Article (original research)
DOI 10.1136/thoraxjnl-2015-208182
Open Access Status Not Open Access
Volume 71
Issue 10
Start page 907
End page 915
Total pages 10
Place of publication London, United Kingdom
Publisher BMJ Publishing Group
Collection year 2017
Language eng
Formatted abstract
Rationale Individual assessment of airway obstruction in preschool-age children requires sensitive and specific lung function methods with low demand of cooperation. Although the forced oscillation technique (FOT) is feasible in young children, conventional measurements of respiratory impedance (Zrs) have limited diagnostic power in individuals.

Objective To find descriptors of within-breath Zrs that are sensitive indicators of airway obstruction during tidal breathing in children.

Methods Zrs was measured with (i) a standard multifrequency FOT (4–26 Hz) to assess the mean values of resistance and reactance for whole breaths and (ii) a 10 Hz signal to track the within-breath changes. Various Zrs measures obtained in healthy children (n=75) and those with acute wheeze (n=31) were investigated with receiver operator characteristic (ROC) analysis. The cut-off values obtained for airway obstruction were then tested in children with recurrent wheeze (n=20) before and after administration of salbutamol.

Results
The largest area under the ROC curve (0.95) was observed for the tidal changes of resistance between the zero-flow values (ΔR). The ΔR cut-off value of 1.42 hPa s/L detected airway obstruction with sensitivity of 92% and specificity of 89% in children with acute wheeze and distinguished children with recurrent wheeze (16/20 above the cut-off value) from healthy children (22/23 below the cut-off value). Furthermore, ΔR significantly decreased after salbutamol in wheezy children but remained unchanged in healthy children.

Conclusions
New lung function measure ΔR is able to detect airway obstruction with high sensitivity and specificity and is suitable for use in lung function testing in young children.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Admin only - CHRC
Child Health Research Centre Publications
 
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