Forced oscillation technique as a predictor for loss of control in asthmatic children

Background: A reliable objective tool using as a predictor of asthma control status could assist asthma management. Objective: To find the parameters of forced oscillation technique (FOT) as predictors for the future loss of asthma symptom control. Methods: Children with well-controlled asthma symptom, aged 6-12 years, were recruited for a 12-week prospective study. FOT and spirometer measures and their bronchodilator response were evaluated at baseline. The level of asthma symptom control was evaluated according to Global Initiative for Asthma. Results: Among 68 recruited children, 41 children (60.3%) maintain their asthma control between 2 visits (group C-C), and 27 children (39.7%) lost their asthma control on the follow-up visit (group C-LC). Baseline FOT parameters, including the values of respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), respiratory reactance at 5 Hz, area of reactance, %predicted of R5 and percentage of bronchodilator response (%) of R5 and R20 were significantly different between C-C and C-LC groups. In contrast, only % of forced vital capacity, forced expiratory volume in 1 second (FEV1), and FEF25%-75% (forced expiratory flow 25%-75%) were significantly different between groups. Multiple logistic regression analysis revealed that %predicted of R5, %R5, %predicted of FEV1 and %FEV1 were the predictive factors for predicting the future loss of asthma control. The following cutoff values demonstrated the best sensitivity and specificity for predicting loss of asthma control: %predicted of R5=91.28, %R5=21.2, %predicted of FEV1=89.5, and %FEV1=7.8. The combination of these parameters predicted the risk of loss of asthma control with area under the curve of 0.924, accuracy of 83.8%. Conclusion: Resistance FOT measures have an additive role to spirometric parameter in predicting future loss of asthma control.