Project Details

Identifying wheezy preschool children at risk of developing asthma using intra-breath oscillometry

Matthew Wong, BSc, MBBS

Summary

BACKGROUND: Nearly 50% of all preschool-aged children worldwide will experience a wheezy illness but only 30% of those with recurrent wheeze will develop asthma. There is no gold standard lung function test for wheezy preschoolers. As a result, empiric corticosteroid treatment of preschool wheeze exposes many children to significant drug side-effects without preventing acute wheezy episodes, relieving airway obstruction, or preventing progression to persistent asthma. GAP: There is no clinically useful test for preschool-aged children that can detect small (but significant) changes in lung function within an individual and identify a response to asthma treatment. HYPOTHESES: Intra-breath oscillometry (IB-Osc) can distinguish healthy children from children with airway obstruction with high sensitivity and specificity. Airway obstruction defined by a difference between respiratory system resistance (Rrs) at end-inspiration and end-expiration (ΔR) ≥ 1.42 hPa·s·L-1 six weeks after an acute wheezy episode predicts the presence of asthma 12 months later. METHODS: A prospective, longitudinal, observational cohort study involving lung function (using the tremoFLO® C-100), medical history, and questionnaires will be collected over a 12-month period in children 3-6 years old presenting to hospital with acute, recurrent wheeze. A group of healthy age-matched children will be recruited as controls. RESULTS: Pending. IMPACT: A lung function test that can track airways disease in individual children would revolutionize the clinical management of preschool wheeze. IB-Osc could be implemented in ambulatory care to detect airways disease early, improve wheeze management pathways and lead to primary prevention strategies that will reduce the burden of asthma on health care systems and families. IB-Osc may help doctors prescribe corticosteroids for the 30% of wheezy preschoolers at risk of asthma and avoid prescribing steroids for the 70% of wheezy preschoolers who do not need it. Website Link: https://child-health-research.centre.uq.edu.au/research/childrens-health-and-environment-program