Lungenfunktionsdiagnostik bei jungen Kindern : Vergleich von Impulsoszillometrie und Spirometrie

Background: Respiratory disorders are common in children. Testing pulmonary function can be useful for making a diagnosis or monitoring the therapy, when there is a prolonged disease process or a chronic lung disease. Methods for testing lung function often need complete cooperation (e.g.: spirometry) or complete inaction (sedation is often needed, e.g.: thorax compression technique). Especially in preschool children testing methods with high cooperation demands are difficult to perform. Spirometry containing computer animation of breathing maneuvers can support cooperation in infants. Impulse oscillometry (IOS) is a new method for testing pulmonary function. Impulse-type measurement signals overlay the respiratory flow and are reflected in airways and in the lung. The reflection pattern is used for analysis of pulmonary function.Patients and Methods: Pulmonary function of 368 school children (1st and 2nd class) and 112 preschool children (ps) from Aachen have been measured by spirometry (computer animation B: „flying bee between flowers“, ps-group: additionally with animation K: “candle-blowing“) and by IOS. Childrens state of health was considered (healthy, acute airway infection, chronic lung disease). The quality of measurement was assessed by different criteria. In addition to the measured values success, number of conducted mesurements and in the preschool group number of tempted measurements, duration and cooperation level was noted. Results: IOS has been performed more successful than spirometry (ps-group 88% vs. 59%). Computer animation B (spirometry) has been performed more successful compared to animation K (ps-group 59% vs. 53%). Boys (success 95%) and healthy infants (92%) have been better in doing a spirometry than girls (84%) and sick infants (87%). It must be considered that the mean age in boys was slightly higher compared to girls. Completing animation B required more time than animation K and IOS (B: 7,4±1,6 min, K: 4,2±0,8 min IOS: 4,4±0,9 min), the duration was independent from age. Cooperation level were higher in IOS compared to spirometry (IOS: 3,2±1,3; B: 2,7±1,2; K: 3±1,2). The number of tempted and conducted measurements were much higher in spirometry (B: 10,6±5,3; K: 6,8±2,9; IOS: 1,8 ± 0,8). Decreasing Age was associated with decreasing success rate more prominent in spirometry (age of 7.: 98%, age of 3.: 14%) than in IOS (age of 3: 56%). Almost all infants with a cooperation level of 1 and more performed successfully IOS, but anyway 14% of infants with the highest cooperation level of 4 failed in doing a spirometry. Cooperation level was positively correlated with increasing age. Success, cooperation, number of tempted and conducted measurements in one method was moderately correlated with the same parameters in the other method. The calculated mean values of spirometry parameters have been in normal range compared to reference values, slightly higher in healthy infants. The calculated mean values of IOS parameters (except for resonance frequency) have been in school children 12-16% below the normal range. In preschool children mean values for impedance Zrs and resistance R (5 Hz) have been 15% above the normal range, the resistance R values (10-25 Hz) 6-29% below the normal range compared to the reference valus. The larger deviation can be seen in higher frequencies. The level of correlation between the intramethodic parameters among each other is diverse. The highest correlation can be seen between FEV1 and FVC, PEF and MEF75 and between the MEF-parameters and respectively between Zrs and R5 and accordingly between Zrs and the reactance X (5 Hz). The intraindividual variation coefficient in IOS was between 6.6 and 8.8%. A correlation between IOS and spirometry can be seen slightly between Zrs, R5, X5 und FEV1 und MEF75. Considering the absolute values Zrs, R5 and X5 correlate with FVC and MEF, too. Zrs and X5 distinguish significantly between healthy infants and infants mit acute respiratroy tract infection. Children with chronic lung diseade had mean values for spirometry and X5 below and for other IOS-parameters above the normal range, the deviation was not statistical significant due to the low sample size. Conclusions: IOS is an additional and low-risk alternative for testing pulmonary function in infants, particularly for detecting obstructive ventilation disorders. Compared to spirometry IOS can be used fast and successfully with good reproducible results even in preschool children. Both ways of measuring pulmonary function provide different, but distinctive information about the airways and the lung.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2008

Author dc:creator

• Cetiner, Metin

Contributors dc:contributor

• Wagner, Norbert

• info:eu-repo/classification/ddc/610
• Lungenfunktion
• Spirometrie
• Impulsoszillometrie
• Vorschulkind
• Bronchialasthma
• Medizin
• pulmonary function
• spirometry
• impulse oscillometry
• IOS

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-112446%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A49878