Relationship between impulse oscillometry system and conventional lung
function test for diagnosis of bronchiolitis obliterans in children
Abstract
Background: Functional assessment of small airways in young children
with bronchiolitis obliterans (BO) is challenging due to their relative
inaccessibility and the generally poor lung function test performance of
these patients. We analyze the correlation between impulse oscillometry
(IOS), spirometry, and plethysmographic parameters in pediatric BO
patients. Methods: A total of 89 IOS assessments of pediatric BO
patients or children without lung disease were included, and the
relationship between pulmonary function tests (PFTs) and diagnostic
performance were analyzed. Results: R5, R5-20, X5, and AX were
statistically significantly worse in the BO group. In Spearman’s
correlation analysis, AX and R5 showed the strongest correlation with
conventional PFT parameters, and AX was the variable with the highest
relative correlation with FEV1, FEF25-75%, and both measures of
plethysmographic resistance. Receiver operating curve analysis
highlighted AX and Raw% pred as the most optimal parameters for BO
diagnostic performance with areas under curve of 0.811 and 0.827,
respectively. Conclusion: The AX and R5 parameters can be useful in
identifying the severity of airway obstruction in children with BO, and
IOS more generally can accurately detect pathological obliteration of
small airways in pediatric BO patients.