Impulse Oscillometry For Accessing Lung Function in Preterm Infants - Video

Existing methods to evaluate lung function in premature infants such as spirometry are limited by the need to perform forced exhalations. While impulse oscillometry (IOS), a non-invasive alternative, permits the measurement of lung respiratory mechanics without requiring forced expiration, there has been no report of an effective multicenter study design utilizing impulse oscillometry to assess the lung function in ELGANs.

A recent study, led by researchers from the Department of Pediatrics at Children’s Hospital of Philadelphia, USA and published in Pediatric Investigation, sheds important light on the suitability of impulse oscillometry for testing lung function in a large multicenter ELGAN population. “Despite the non-invasive nature of IOS, it has not been widely utilized to evaluate lung health in the ELGAN population. This motivated us to report our methods and success in implementing a multicenter protocol for obtaining research-quality oscillometry data in extremely preterm children,” explains Dr. Katharine Tsukahara, the lead author of the study.

In their study, the researchers recruited early school-age preterm children with a high risk of BPD from the Hydrocortisone for Bronchopulmonary Dysplasia Respiratory and Developmental (HYBRiD) Outcomes Study, along with preterm children with minimal BPD or no lung disease from the Transfusion of Prematures Early School Age Follow-Up (TOP 5) study. Additionally, full-term children with healthy lungs were utilized to enable effective comparison across different study groups.

A 6-minute walk test and the International Study of Asthma and Allergies in Childhood questionnaire were employed across five Neonatal Research Network (NRN) centers to evaluate respiratory function in the study participants. impulse oscillometry was performed according to the Childhood Asthma Research and Education (CARE) Network procedures. To ensure the research quality of oscillometry data, the impulse oscillometry reports were reviewed based on five quality criteria from the CARE Network for oscillometry studies in pediatric asthma.

Around 98% of the study participants attempted the oscillometry test. The technical acceptability of IOS across the three study groups was high and varied between 85%–90% of the attempted tests. Moreover, the acceptability across the five NRN centers remained high.

Additionally, the researchers investigated whether any clinical factor hindered the likelihood of producing acceptable oscillometry data in the study population. They found that lower birth weight, number of days requiring ventilation during neonatal intensive care unit course, and neuromotor comorbidities were associated with a higher rate of failure during impulse oscillometry testing.

Reference: Tsukahara, K., Ren, C. L., Allen, J., Bann, C., McDonough, J., Ziolkowski, K., ... & DeMauro, S. B. (2024). Design and implementation of a multicenter protocol to obtain impulse oscillometry data in preterm children. Pediatric Investigation.