{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:27:15Z","timestamp":1785904035164,"version":"3.56.0"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In preschoolers, performing an acceptable spirometry and measuring bronchodilator response (BDR) is challenging; in this context, impulse oscillometry (IOS) represents a valid alternative. However, more studies on the standardization of BDR for IOS in young children are required.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of the study was to identify optimal thresholds to define a positive BDR test with IOS in preschoolers with suspected asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children aged 3\u20136 years with suspected asthma and their lung function investigated with both IOS and spirometry pre\u2010 and post\u2010BDR were retrospectively analyzed. The spirometric BDR was defined as positive when the change of FEV<jats:sub>1<\/jats:sub> was \u226512% or \u2265200\u2009mL. The oscillometric BDR was defined as positive in case of change of at least \u221240% in R5, +50% in X5, and \u221280% in AX.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 72 patients, 36 (age 5.2\u2009\u00b1\u20091 years; 64% boys) were selected for the subsequent analysis according to ATS\/ERS quality criteria of measurements; specifically, 19 patients did not meet IOS and 36 did not meet spirometry criteria. The spirometric BDR was found positive in seven subjects (19.4%); conversely, a positive oscillometric BDR was identified in four patients (11.1%). No patient presented a positive BDR response with both methods. In IOS, the mean decrease in R5 and AX was 19.9%\u2009\u00b1\u200910% and 44%\u2009\u00b1\u200922.1%, and the mean increase in X5 was 23.3%\u2009\u00b1\u200917.8%, respectively. A decrease in R5 of 25.7% (AUC 0.77, <jats:italic>p<\/jats:italic>\u2009=\u2009.03) and an increase in X5 of 25.7% (AUC 0.75, <jats:italic>p<\/jats:italic>\u2009=\u2009.04) showed the best combination of sensitivity and specificity to detect an increase of FEV<jats:sub>1<\/jats:sub>\u2009\u2265\u200912% and\/or \u2265200\u2009mL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The IOS represents a valid alternative to spirometry to measure BDR in preschool children and should be the gold standard in this age group. We are considering a decrease of 26% in R5 and an increase of 26% in X5 as diagnostic threshold for BDR.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26909","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T10:54:30Z","timestamp":1707908070000},"page":"1321-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impulse oscillometry bronchodilator response in preschool children"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3343-4051","authenticated-orcid":false,"given":"Aniello","family":"Meoli","sequence":"first","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"},{"name":"Department of Medicine and Surgery, Pediatric Clinic University Hospital of Parma Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordis","family":"Trischler","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hutter","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Dressler","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Pediatric Clinic University Hospital of Parma Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5129-852X","authenticated-orcid":false,"given":"Katharina","family":"Bl\u00fcmchen","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1204-0627","authenticated-orcid":false,"given":"Stefan","family":"Zielen","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3022-3849","authenticated-orcid":false,"given":"Johannes","family":"Schulze","sequence":"additional","affiliation":[{"name":"Department for Children and Adolescents, Division of Allergology Pulmonology and Cystic fibrosis Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"e_1_2_17_2_1","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention.2022. Accessed November 10 2022.https:\/\/ginasthma.org\/wp-content\/uploads\/2022\/07\/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.04173-2020"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2018-0282"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(19)30046-4"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25592"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022363"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23968"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00199913"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60615-2"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13334"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199501193320301"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S178531"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0000000000000815"},{"key":"e_1_2_17_15_1","volume-title":"Asthma: Diagnosis, Monitoring and Chronic Asthma Management","author":"National Institute for Health and Care Excellence","year":"2021"},{"key":"e_1_2_17_16_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X713033"},{"key":"e_1_2_17_17_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01499-2021"},{"key":"e_1_2_17_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2020.1813573"},{"key":"e_1_2_17_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2008.00734.x"},{"key":"e_1_2_17_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23794"},{"key":"e_1_2_17_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.01.007"},{"key":"e_1_2_17_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000442448"},{"key":"e_1_2_17_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21492"},{"key":"e_1_2_17_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2021.03.030"},{"key":"e_1_2_17_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25374"},{"key":"e_1_2_17_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13223-023-00835-x"},{"key":"e_1_2_17_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2009.11.006"},{"key":"e_1_2_17_28_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.4.2427"},{"key":"e_1_2_17_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1745-9974-5-3"},{"key":"e_1_2_17_30_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0208-2021"},{"key":"e_1_2_17_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2011.07.011"},{"issue":"2","key":"e_1_2_17_32_1","first-page":"184","article-title":"Use of forced oscillation technique to detect airflow limitations in adult Japanese asthmatics","volume":"61","author":"Tsuburai T","year":"2012","journal-title":"Arerugi [in Japanese]"},{"key":"e_1_2_17_33_1","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2020.12.5.832"},{"key":"e_1_2_17_34_1","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.1627"},{"key":"e_1_2_17_35_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00023409"},{"key":"e_1_2_17_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.071290"},{"key":"e_1_2_17_37_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.12020438"},{"key":"e_1_2_17_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.58.6.494"},{"key":"e_1_2_17_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.21223"},{"key":"e_1_2_17_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8091475"},{"key":"e_1_2_17_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13418"},{"key":"e_1_2_17_42_1","doi-asserted-by":"publisher","DOI":"10.3109\/02770901003624259"},{"key":"e_1_2_17_43_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00753-2019"},{"key":"e_1_2_17_44_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.4.2006119"},{"key":"e_1_2_17_45_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-097X.2002.00396.x"},{"key":"e_1_2_17_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22699"},{"key":"e_1_2_17_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.01.058"},{"key":"e_1_2_17_48_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-1465"},{"key":"e_1_2_17_49_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"e_1_2_17_50_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"issue":"62","key":"e_1_2_17_51_1","article-title":"Is there any association between spirometry and impulse oscillometry in asthmatic preschool children?","volume":"52","author":"Carvalho Vidal Reis Leiria Pinto PC","year":"2018","journal-title":"Eur Respir J"},{"issue":"2","key":"e_1_2_17_52_1","first-page":"102","article-title":"Comparative analysis of the bronchodilator response measured by impulse oscillometry (IOS), spirometry and body plethysmography in asthmatic children","volume":"15","author":"Olagu\u00edbel JM","year":"2005","journal-title":"J Investig Allergol Clin Immunol"},{"key":"e_1_2_17_53_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/560323"},{"key":"e_1_2_17_54_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00035205"},{"key":"e_1_2_17_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.690333"},{"key":"e_1_2_17_56_1","volume-title":"Lung Function Measurements Using Forced Oscillation in Young Children","author":"Gleason M","year":"2001"},{"key":"e_1_2_17_57_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.908607"},{"key":"e_1_2_17_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26632"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T10:23:30Z","timestamp":1739269410000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,14]]},"references-count":57,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1002\/ppul.26909"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26909","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,14]]},"assertion":[{"value":"2023-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}