Forced oscillation technique as a predictor for loss of control in asthmatic children
10.5415/apallergy.2020.10.e3
- Author:
Piyawut KREETAPIROM
1
;
Potjanee KIEWNGAM
;
Wanlapa JOTIKASTHIRA
;
Wasu KAMCHAISATIAN
;
Suwat BENJAPONPITAK
;
Wiparat MANUYAKORN
Author Information
1. Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. mwiparat@hotmail.com
- Publication Type:Original Article
- Keywords:
Resistance;
Reactance;
Spirometry;
Frequency of resonance;
Asthma
- MeSH:
Asthma;
Child;
Follow-Up Studies;
Forced Expiratory Volume;
Humans;
Logistic Models;
Prospective Studies;
Sensitivity and Specificity;
Spirometry;
Vital Capacity
- From:
Asia Pacific Allergy
2020;10(1):3-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: A reliable objective tool using as a predictor of asthma control status could assist asthma management.OBJECTIVE: To find the parameters of forced oscillation technique (FOT) as predictors for the future loss of asthma symptom control.METHODS: Children with well-controlled asthma symptom, aged 6–12 years, were recruited for a 12-week prospective study. FOT and spirometer measures and their bronchodilator response were evaluated at baseline. The level of asthma symptom control was evaluated according to Global Initiative for Asthma.RESULTS: Among 68 recruited children, 41 children (60.3%) maintain their asthma control between 2 visits (group C-C), and 27 children (39.7%) lost their asthma control on the follow-up visit (group C-LC). Baseline FOT parameters, including the values of respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), respiratory reactance at 5 Hz, area of reactance, %predicted of R5 and percentage of bronchodilator response (%∆) of R5 and R20 were significantly different between C-C and C-LC groups. In contrast, only %∆ of forced vital capacity, forced expiratory volume in 1 second (FEV₁), and FEF25%–75% (forced expiratory flow 25%–75%) were significantly different between groups. Multiple logistic regression analysis revealed that %predicted of R5, %∆R5, %predicted of FEV₁ and %∆FEV₁ were the predictive factors for predicting the future loss of asthma control. The following cutoff values demonstrated the best sensitivity and specificity for predicting loss of asthma control: %predicted of R5=91.28, %∆R5=21.2, %predicted of FEV₁=89.5, and %∆FEV₁=7.8. The combination of these parameters predicted the risk of loss of asthma control with area under the curve of 0.924, accuracy of 83.8%.CONCLUSION: Resistance FOT measures have an additive role to spirometric parameter in predicting future loss of asthma control.
