Am. J. Respir. Crit. Care Med., Volume 161, Number 3, March 2000, 730-736

Use of the Forced Oscillation Technique to Assess Airway Obstruction and Reversibility in Children

CHRISTOPHE DELACOURT, HUBERT LORINO, MARTINE HERVE-GUILLOT, PHILIPPE REINERT, ALAIN HARF, and BRUNO HOUSSET

Service de Pédiatrie and Service de Pneumologie, Centre Hospitalier Intercommunal de Créteil, Créteil; INSERM U492, Faculté de Médecine de Créteil, Créteil; and Service de Physiologie-Explorations Fonctionnelles, Hôpital Henri Mondor, Créteil, France

The forced oscillation technique (FOT) is particularly attractive in a pediatric setting as it requires only passive cooperation from the child. We assessed the sensitivity and specificity of this method for detecting airway obstruction and its reversibility in 313 children (3 to 16 yr of age) with asthma or chronic nocturnal cough. Baseline and postbronchodilator (n = 251) resistance were measured (R₀) with the FOT. Baseline R₀ was normalized for height and weight [R₀(SD)]. In children able to perform forced expiratory maneuvers (n = 181), R₀(SD) was independently correlated with FEV₁ (p < 0.02) and maximal expiratory flow at 50% (MEF₅₀) (p < 0.004). The optimal R₀(SD) cutoff value given by receiver operating characteristic (ROC) curves to discriminate between children with baseline FEV₁ < 80% or  80% of predicted values yielded 84% sensitivity and 73% specificity. Postbronchodilator changes in R₀(SD) [R₀(SD)] were mostly correlated to changes in MEF₅₀. The optimal R₀(SD) cutoff value to discriminate between children with the presence or absence of significant reversibility in FEV₁ yielded 69% sensitivity and 78% specificity. In children unable to perform forced expiratory maneuvers (n = 132), this R₀(SD) cutoff clearly identified a subgroup of young children with high R₀ values at baseline, that returned to normal after bronchodilation. We conclude that FOT measurements allow reliable evaluation of bronchial obstruction and its reversibility in asthmatic children over 3 yr old. Delacourt C, Lorino H, Herve-Guillot M, Reinert P, Harf A, Housset B. Use of the forced oscillation technique to assess airway obstruction and reversibility in children.

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