Comparison of the forced oscillation technique and the interrupter technique for assessing airway obstruction and its reversibility in children

The forced oscillation technique (FOT) and interrupter technique are particularly attractive for pediatric use as they require only passive cooperation from the patient. We compared the sensitivity and specificity of these methods for detecting airway obstruction and its reversibility in 118 children (3-16 yr) with asthma or chronic nocturnal cough, FOT (R-0 and R-16) and interruption (Rint) parameters were measured at baseline and after bronchodilator inhalation (n = 94). Rint was significantly lower than R-0, especially in children with high baseline values. Baseline parameters were normalized for height and weight [R(SD)]. In children able to perform forced expiratory maneuvers (n = 93), the best discrimination between those with baseline FEV1 <80% or <greater than or equal to>80% of predicted values was obtained with R-0(SD). At a specificity of 80%, R-0(SD) yielded 66% sensitivity, whereas Rint(SD) yielded only 33% sensitivity. Similarly, postbronchodilator changes in R-0(SD) [DeltaR(0)(SD)] yielded the best discrimination between children with and without significant reversibility in FEV1. At a specificity of 80%, DeltaR(0)(SD) yielded 67% sensitivity and Delta Rint(SD) yielded 58% sensitivity. In children unable to perform forced expiratory maneuvers (n = 25), FOT, contrary to the interrupter technique, clearly identified a subgroup of young children with high resistance values at baseline, which returned to normal after bronchodilation. We conclude that, in asthmatic children over 3 yr old, FOT measurements provide a more reliable evaluation of bronchial obstruction and its reversibility compared with the interrupter technique, especially in young children with high baseline values.