Impulse Oscillometry May Detect Early Lung Dysfunction in Preschool Children With BPD: Study
USA: Researchers have found in a new study that impulse oscillometry (IOS) is a feasible and objective method for assessing lung function in preschool-aged children with bronchopulmonary dysplasia (BPD). About half of these children can successfully perform the test, which identifies increased airway resistance and reduced lung reactance that improve with bronchodilator therapy. IOS may help detect early respiratory abnormalities and monitor treatment response in young children who are unable to undergo conventional pulmonary function testing.
Published in The Journal of Pediatrics, the study by Daniela Bullard Elias and colleagues assessed the utility of impulse oscillometry for measuring lung function in children aged 3–6 years with bronchopulmonary dysplasia, a group in whom conventional spirometry is often difficult to perform.
Researchers retrospectively reviewed 103 IOS assessments from 73 children with BPD, with a median age of 4.1 years. Clinical data were obtained from electronic medical records, and respiratory health was evaluated using a modified St. George’s Respiratory Questionnaire. Overall, 52% of IOS tests met acceptability and repeatability criteria, demonstrating that the technique is feasible in a substantial proportion of preschool-aged children with BPD.
Key findings from the study included:
- At least one abnormal IOS parameter was identified in 78% of assessments.
- Children commonly exhibited increased airway resistance, particularly in the peripheral airways.
- Reduced lung reactance, indicating impaired lung mechanics, was frequently observed.
- Lung function measurements improved after administration of albuterol, suggesting reversible airway obstruction.
- Children receiving inhaled corticosteroid and long-acting beta-agonist therapy showed improvements in airway resistance and reactance during follow-up testing.
- Participants experienced a considerable burden of respiratory symptoms and health-related morbidity based on questionnaire assessments.
The findings suggest that airway abnormalities in preschool children with BPD may be more prevalent and more responsive to bronchodilator therapy than previously recognized. The researchers noted that IOS provides a practical, noninvasive method for detecting these abnormalities and monitoring treatment response during early childhood.
The study had several limitations, including its retrospective design, reliance on electronic medical records, loss of some patients to follow-up, and the inability of many children—particularly younger children and boys—to complete IOS testing successfully. The lack of a healthy control group and the use of reference values from a Canadian cohort may also limit the generalizability of the findings.
The researchers concluded that preschool-aged children with BPD commonly exhibit elevated airway resistance and reduced reactance that improve with bronchodilator therapy. They highlighted IOS as a promising objective tool for assessing lung function and treatment response in young children who cannot perform conventional pulmonary function tests.
Reference:
Bullard Elias, D., Amin, R., Ignatiuk, D., Pajor, N., Keegan, D., Bellew, L., Woods, J., & Hysinger, E. (2026). Reversible Airway Obstruction on Impulse Oscillometry in Preschool Children with Bronchopulmonary Dysplasia. The Journal of Pediatrics, 293, 115013. https://doi.org/10.1016/j.jpeds.2026.115013
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