Use of the forced oscillation technique to detect bronchodilation in children: experience from the Schneider Children's Medical Center of Israel.
BACKGROUND
The forced oscillation technique is a noninvasive and effort-independent technique that is well suited for lung function measurement in young children. FOT employs small-amplitude pressure oscillations superimposed on normal breathing. Therefore, it has the advantage over conventional lung function techniques in that it does not require patient cooperation for conducting respiratory maneuvers.


OBJECTIVE
To test the feasibility of the FOT test in preschool children and to compare the results to the commonly used spirometry before and after the administration of bronchodilator therapy.


METHODS
Forty-six children (median age 4.9 years, range 1.8-18.3) attending the pulmonary clinic at Schneider Children's Medical Center tried to perform FOT and routine spirometry. Results were retrospectively analyzed.


RESULTS
Of the 46 children 40 succeeded in performing FOT and only 29 succeeded in performing simple spirometry. All but one of the 32 children aged 4 years and above (97%) could perform both tests. Nine of 14 children (64%) aged 4 and less could perform the FOT but only 3 (21%) could perform spirometry. Baseline values of respiratory resistance measured at 6 Hz (R6) negatively correlated with body length (r2 = 0.68, P < 0.005). Twenty-four children performed both tests before and after bronchodilator therapy. A significant concordance was found between the measured responses to bronchodilators by FOT and spirometry (P < 0.01). Only one child had a negative response by FOT but a positive response by spirometry.


CONCLUSIONS
The FOT is a simple, non-invasive technique that does not require subject cooperation and thus can be utilized for measuring lung function in children as young as 2 years old. Furthermore, the FOT was shown to reliably measure response to bronchodilator therapy.
Bar-Yishay
Ephraim
E
Cykiert Pulmonary Function Laboratory, Pediatric Pulmonary Institute, Schneider Children's Medical Center of Israel, Petah Tikva, Israel. ephraimb@clalit.org.il
Matyashchuk
Elena
E
Mussaffi
Huda
H
Mei-Zahav
Meir
M
Prais
Dario
D
Hananya
Shai
S
Steuer
Guy
G
Blau
Hannah
H
D000293:Adolescent; D000367:Age Factors; D000420:Albuterol / Q000008:administration & dosage; D001982:Bronchial Diseases / Q000175:diagnosis*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007557:Israel; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests / Q000295:instrumentation / Q000379:methods*; D015656:Respiratory Mechanics; D012189:Retrospective Studies; D013147:Spirometry
D001993:Bronchodilator Agents; D000420:Albuterol