Increased day-to-day variability of forced oscillatory resistance in poorly controlled or persistent pediatric asthma

Paul D. Robinson; Nathan J. Brown; Martin Turner; Peter Van Asperen; Hiran Selvadurai; Gregory G. King

doi:10.1378/chest.14-0288

Increased day-to-day variability of forced oscillatory resistance in poorly controlled or persistent pediatric asthma

Paul D. Robinson^*, Nathan J. Brown, Martin Turner, Peter Van Asperen, Hiran Selvadurai, Gregory G. King

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

15 Citations (Scopus)

Abstract

BACKGROUND: Pediatric asthma lacks sensitive objective measures for asthma monitoring. The forced oscillation technique (FOT) offers strong feasibility across the pediatric age range, but relationships between FOT parameter day-to-day variability and pediatric asthma severity and control are unknown.

METHODS: Day-to-day variability in FOT respiratory system resistance (Rrs) and respiratory system reactance (Xrs) compared with peak expiratory flow (PEF) were defined in 22 children with asthma (mean ± SD age, 10.4 ± 1.1 years) during a 5-day asthma camp. FOT was performed at 6 Hz in triplicate on each test occasion. Relationships between day-to-day FOT variability (expressed as within-subject SD [SDW ] and asthma control and severity (defined according to GINA [Global Initiative for Asthma] recommendations) were explored. For comparison, normal baseline FOT values and variability, measured on two occasions, were defined in a separate cohort of 38 healthy children (age, 9.5 ± 1.0 years).

RESULTS: Day-to-day Rrs variability was greater in persistent (n = 16) vs intermittent (n = 6) asthma (mean SDW, 0.69 cm H₂O/L/s vs 0.39 cm H₂O/L/s; P ≤ .01). Day-to-day Rrs variability was increased in uncontrolled (n = 13) vs partly controlled asthma (n 5 9) (mean SDW, 0.75 cm H₂O/L/s vs 0.42 cm H₂O/L/s; P ≤ .05). PEF variability did not differentiate the groups. Day-to-day variability of Rrs and Xrs but not baseline values were increased in children with asthma vs control children (Rrs mean SDW, 0.61 cm H₂O/L/s vs 0.33 cm H₂O/L/s [ P ≤ .05]; Xrs mean SDW, 0.24 cm H₂O/L/s vs 0.15 cm H₂O/L/s [ P ≤ .05]).

CONCLUSIONS: Increased day-to-day FOT variability exists in school-aged children with asthma. Day-to-day Rrs variability was associated with asthma severity and asthma control. FOT may be a useful objective monitoring tool in pediatric asthma and warrants further study .

TRIAL REGISTRY: Australian and New Zealand Clinical Trials Registry; No.: ACTRN12614000885695; URL: Www.anzctr.org.au.

Original language	English
Pages (from-to)	974-981
Number of pages	8
Journal	Chest
Volume	146
Issue number	4
DOIs	https://doi.org/10.1378/chest.14-0288
Publication status	Published - 1 Oct 2014
Externally published	Yes

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@article{fd9c3b5beaf845f58dcb9379b7ddb6a0,

title = "Increased day-to-day variability of forced oscillatory resistance in poorly controlled or persistent pediatric asthma",

abstract = "BACKGROUND: Pediatric asthma lacks sensitive objective measures for asthma monitoring. The forced oscillation technique (FOT) offers strong feasibility across the pediatric age range, but relationships between FOT parameter day-to-day variability and pediatric asthma severity and control are unknown.METHODS: Day-to-day variability in FOT respiratory system resistance (Rrs) and respiratory system reactance (Xrs) compared with peak expiratory flow (PEF) were defined in 22 children with asthma (mean ± SD age, 10.4 ± 1.1 years) during a 5-day asthma camp. FOT was performed at 6 Hz in triplicate on each test occasion. Relationships between day-to-day FOT variability (expressed as within-subject SD [SDW ] and asthma control and severity (defined according to GINA [Global Initiative for Asthma] recommendations) were explored. For comparison, normal baseline FOT values and variability, measured on two occasions, were defined in a separate cohort of 38 healthy children (age, 9.5 ± 1.0 years).RESULTS: Day-to-day Rrs variability was greater in persistent (n = 16) vs intermittent (n = 6) asthma (mean SDW, 0.69 cm H2O/L/s vs 0.39 cm H2O/L/s; P ≤ .01). Day-to-day Rrs variability was increased in uncontrolled (n = 13) vs partly controlled asthma (n 5 9) (mean SDW, 0.75 cm H2O/L/s vs 0.42 cm H2O/L/s; P ≤ .05). PEF variability did not differentiate the groups. Day-to-day variability of Rrs and Xrs but not baseline values were increased in children with asthma vs control children (Rrs mean SDW, 0.61 cm H2O/L/s vs 0.33 cm H2O/L/s [ P ≤ .05]; Xrs mean SDW, 0.24 cm H2O/L/s vs 0.15 cm H2O/L/s [ P ≤ .05]).CONCLUSIONS: Increased day-to-day FOT variability exists in school-aged children with asthma. Day-to-day Rrs variability was associated with asthma severity and asthma control. FOT may be a useful objective monitoring tool in pediatric asthma and warrants further study .TRIAL REGISTRY: Australian and New Zealand Clinical Trials Registry; No.: ACTRN12614000885695; URL: Www.anzctr.org.au.",

author = "Robinson, {Paul D.} and Brown, {Nathan J.} and Martin Turner and {Van Asperen}, Peter and Hiran Selvadurai and King, {Gregory G.}",

year = "2014",

month = oct,

day = "1",

doi = "10.1378/chest.14-0288",

language = "English",

volume = "146",

pages = "974--981",

journal = "Chest",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "4",

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T1 - Increased day-to-day variability of forced oscillatory resistance in poorly controlled or persistent pediatric asthma

AU - Robinson, Paul D.

AU - Brown, Nathan J.

AU - Turner, Martin

AU - Van Asperen, Peter

AU - Selvadurai, Hiran

AU - King, Gregory G.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - BACKGROUND: Pediatric asthma lacks sensitive objective measures for asthma monitoring. The forced oscillation technique (FOT) offers strong feasibility across the pediatric age range, but relationships between FOT parameter day-to-day variability and pediatric asthma severity and control are unknown.METHODS: Day-to-day variability in FOT respiratory system resistance (Rrs) and respiratory system reactance (Xrs) compared with peak expiratory flow (PEF) were defined in 22 children with asthma (mean ± SD age, 10.4 ± 1.1 years) during a 5-day asthma camp. FOT was performed at 6 Hz in triplicate on each test occasion. Relationships between day-to-day FOT variability (expressed as within-subject SD [SDW ] and asthma control and severity (defined according to GINA [Global Initiative for Asthma] recommendations) were explored. For comparison, normal baseline FOT values and variability, measured on two occasions, were defined in a separate cohort of 38 healthy children (age, 9.5 ± 1.0 years).RESULTS: Day-to-day Rrs variability was greater in persistent (n = 16) vs intermittent (n = 6) asthma (mean SDW, 0.69 cm H2O/L/s vs 0.39 cm H2O/L/s; P ≤ .01). Day-to-day Rrs variability was increased in uncontrolled (n = 13) vs partly controlled asthma (n 5 9) (mean SDW, 0.75 cm H2O/L/s vs 0.42 cm H2O/L/s; P ≤ .05). PEF variability did not differentiate the groups. Day-to-day variability of Rrs and Xrs but not baseline values were increased in children with asthma vs control children (Rrs mean SDW, 0.61 cm H2O/L/s vs 0.33 cm H2O/L/s [ P ≤ .05]; Xrs mean SDW, 0.24 cm H2O/L/s vs 0.15 cm H2O/L/s [ P ≤ .05]).CONCLUSIONS: Increased day-to-day FOT variability exists in school-aged children with asthma. Day-to-day Rrs variability was associated with asthma severity and asthma control. FOT may be a useful objective monitoring tool in pediatric asthma and warrants further study .TRIAL REGISTRY: Australian and New Zealand Clinical Trials Registry; No.: ACTRN12614000885695; URL: Www.anzctr.org.au.

AB - BACKGROUND: Pediatric asthma lacks sensitive objective measures for asthma monitoring. The forced oscillation technique (FOT) offers strong feasibility across the pediatric age range, but relationships between FOT parameter day-to-day variability and pediatric asthma severity and control are unknown.METHODS: Day-to-day variability in FOT respiratory system resistance (Rrs) and respiratory system reactance (Xrs) compared with peak expiratory flow (PEF) were defined in 22 children with asthma (mean ± SD age, 10.4 ± 1.1 years) during a 5-day asthma camp. FOT was performed at 6 Hz in triplicate on each test occasion. Relationships between day-to-day FOT variability (expressed as within-subject SD [SDW ] and asthma control and severity (defined according to GINA [Global Initiative for Asthma] recommendations) were explored. For comparison, normal baseline FOT values and variability, measured on two occasions, were defined in a separate cohort of 38 healthy children (age, 9.5 ± 1.0 years).RESULTS: Day-to-day Rrs variability was greater in persistent (n = 16) vs intermittent (n = 6) asthma (mean SDW, 0.69 cm H2O/L/s vs 0.39 cm H2O/L/s; P ≤ .01). Day-to-day Rrs variability was increased in uncontrolled (n = 13) vs partly controlled asthma (n 5 9) (mean SDW, 0.75 cm H2O/L/s vs 0.42 cm H2O/L/s; P ≤ .05). PEF variability did not differentiate the groups. Day-to-day variability of Rrs and Xrs but not baseline values were increased in children with asthma vs control children (Rrs mean SDW, 0.61 cm H2O/L/s vs 0.33 cm H2O/L/s [ P ≤ .05]; Xrs mean SDW, 0.24 cm H2O/L/s vs 0.15 cm H2O/L/s [ P ≤ .05]).CONCLUSIONS: Increased day-to-day FOT variability exists in school-aged children with asthma. Day-to-day Rrs variability was associated with asthma severity and asthma control. FOT may be a useful objective monitoring tool in pediatric asthma and warrants further study .TRIAL REGISTRY: Australian and New Zealand Clinical Trials Registry; No.: ACTRN12614000885695; URL: Www.anzctr.org.au.

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DO - 10.1378/chest.14-0288

M3 - Article

C2 - 24991854

AN - SCOPUS:84907933496

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JO - Chest

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Increased day-to-day variability of forced oscillatory resistance in poorly controlled or persistent pediatric asthma

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