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Regression Equations of Respiratory Impedance Measured by Forced Oscillation Technique for Indian Children

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Abstract

Objective

To develop regression equations of within and whole-breath respiratory impedance for Indian children aged 5 to 17 y.

Methods

A prospective cross-sectional study was carried out in 5 to 17 y old school children of Bhopal, India. Healthy children were identified by physical examination and by administering questionnaire. The respiratory system resistance (Rrs) and reactance (Xrs) were measured at frequency of 5, 11, and 19 Hz by forced oscillation technique (FOT). The regression equations of within and whole-breath Rrs and Xrs were developed separately for boys and girls by multiple linear regression models.

Results

Total 336 children were recruited and data of 320 healthy children (boys – 159), standing height of 146.1 ± 16.6 cm and body mass index of 17.2 ± 2.9 kg/m2 were included in the analysis. The mean respiratory system resistance at 5 Hz (R5) and respiratory system reactance at 5 Hz (X5) of the children, irrespective of gender were 5.46 ± 2.10 cmH2O/L/s and − 1.43 ± 0.85 cmH2O/L/s respectively. Boys of age 16 y and older had significantly smaller Rrs as compared to girls of corresponding age (p < 0.05). The standing height of children had the highest predictive power, followed by age in the regression model. With an increase in standing height, the magnitude of both Rrs and Xrs values of children decrease. The bodyweight of children had a negligible contribution to the regression models.

Conclusions

The regression equations of within- and whole-breath Rrs and Xrs of Indian children aged 5 to 17 y are presented for the first time. The R5 values of Indian children were comparable to children of other ethnicities.

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References

  1. 1.

    National Asthma Education and Prevention Program. Expert Panel Report 3(EPR-3): Guidelines for the diagnosis and management of asthma-Summary Report 2007. J Allergy Clin Immunol. 2007;120: S94–138.

  2. 2.

    Heijkenskjöld Rentzhog C, Janson C, Berglund L, et al. Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control. Clin Exp Allergy. 2017;47:1546–54.

  3. 3.

    Alblooshi A, Alkalbani A, Albadi G, Narchi H, Hall G. Is forced oscillation technique the next respiratory function test of choice in childhood asthma. World J Methodol. 2017;7:129–38.

  4. 4.

    Pearce N, Aït-Khaled N, Beasley R, et al; The ISAAC Phase Three Study Group. Worldwide trends in the prevalence of asthma symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007;62:758–66.

  5. 5.

    Oostveen E, MacLeod D, Lorino H, et al; ERS Task Force on Respiratory Impedance Measurements. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J. 2003;22:1026–41.

  6. 6.

    Nowowiejska B, Tomalak W, Radliński J, Siergiejko G, Latawiec W, Kaczmarski M. Transient regression values for impulse oscillometry for children aged 3-18 years. Pediatr Pulmonol. 2008;43:1193–7.

  7. 7.

    de Assumpção MS, Gonçalves RM, Martins R, Bobbio TG, Schivinski CS. Reference equations for impulse oscillometry system parameters in healthy Brazilian children and adolescents. Respir Care. 2016;61:1090–9.

  8. 8.

    Dencker M, Malmberg LP, Valind S, et al. Reference values for respiratory system impedance by using impulse oscillometry in children aged 2-11 years. Clin Physiol Funct Imaging. 2006;26:247–50.

  9. 9.

    Gochicoa-Rangel L, Torre-Bouscoulet L, Martínez-Briseño D, Rodríguez-Moreno L, Cantú-González G, Vargas MH. Values of impulse oscillometry in healthy Mexican children and adolescent. Respir Care. 2015;60:119–27.

  10. 10.

    Khadilkar V, Yadav S, Agrawal KK, et al; Indian Academy of Pediatrics Growth Charts Committee. Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children. Indian Pediatr. 2015;52:47–55.

  11. 11.

    Frei J, Jutla J, Kramer G, Hatzakis GE, Ducharme FM, Davis GM. Impulse oscillometry: reference values in children 100 to 150 cm in height and 3 to 10 years of age. Chest. 2005;128:1266–73.

  12. 12.

    Ducharme FM, Jroundi I, Jean G, Lavoie Boutin G, Lawson C, Vinet B. Inter device agreement in respiratory resistance values by oscillometry in asthmatic children. ERJ Open Res. 2019;5:pii: 00138-2018.

  13. 13.

    Chhabra SK, Kumar R, Mittal V. Prediction equations for spirometry for children from northern India. Indian Pediatr. 2016;53:781–5.

  14. 14.

    Narchi H, Al Blooshi A. Prediction equations of forced oscillation technique: the insidious role of collinearity. Respir Res. 2018;19:48.

  15. 15.

    Paredi P, Goldman M, Alamen A, et al. Comparison of inspiratory and expiratory resistance and reactance in patients with asthma and chronic obstructive pulmonary disease. Thorax. 2010;65:263–7.

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Acknowledgments

The authors would like to thank Indian Council of Medical Research for funding. They also thank their staff Mr. Gagan Deep Singh Kushwah, Mr. Dharmendra Dharwey, Mr. Mohd Qmar Khan and Gagan Dhaneshwar for their contribution in collecting the data.

Author information

SD designed the study, made the protocol and drafted the final manuscript. NB helped to collect the data and RRT helped in analysis. All authors contributed to the finalization of the manuscript. SD is the guarantor for this article.

Correspondence to Sajal De.

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Source of Funding

Indian Council of Medical Research.

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De, S., Banerjee, N. & Tiwari, R.R. Regression Equations of Respiratory Impedance Measured by Forced Oscillation Technique for Indian Children. Indian J Pediatr 87, 192–199 (2020). https://doi.org/10.1007/s12098-019-03116-x

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Keywords

  • Forced oscillation technique
  • Within-breath
  • Whole-breath
  • Respiratory impedance
  • Regression equations
  • Children