Allen Julian Lewis, Ren Clement L, McDonough Joseph, Clem Charles C
Division of Pulmonary Medicine The Children's Hospital of Philadelphia Philadelphia PA USA.
Riley Hospital for Children Indiana University School of Medicine Indianapolis IN USA.
Pediatr Investig. 2019 Dec 21;3(4):257-260. doi: 10.1002/ped4.12169. eCollection 2019 Dec.
Impulse oscillometry (IOS) employs high frequency sinusoidal or impulse pressure and flow waveforms to interrogate the mechanical properties of the respiratory system. It has special applications to preschool and younger children who may have difficulty performing the repetitive forced expiratory maneuvers required for spirometry.
We present a case illustrating improvements of respiratory system mechanics measured by IOS in a 6-year-old child with cystic fibrosis (CF) who demonstrated clinical and radiological improvement after a course of therapy with hospitalization and intravenous antibiotics, and initiation of a cystic fibrosis transmembrane regulator (CFTR) protein corrector/potentiator agent. We also report a new finding: observed lower than expected reactance at low compared to high frequencies ("reactance inversion").
Reactance inversion may reflect parallel pathway inhomogeneities in resistance and elastance or intrabreath airway inertance changes in young children with CF. Further study is needed in children with airway obstruction due to asthma, cystic fibrosis, and chronic lung disease of infancy to demonstrate the prevalence of this finding and whether it is specific to a measurement device.
脉冲振荡法（IOS）采用高频正弦或脉冲压力及流量波形来探究呼吸系统的力学特性。它对那些可能难以完成肺量计所需的重复性用力呼气动作的学龄前儿童及更小的儿童有特殊应用价值。
我们呈现一例6岁囊性纤维化（CF）患儿的病例，该患儿在经过住院及静脉使用抗生素治疗疗程，并开始使用囊性纤维化跨膜传导调节因子（CFTR）蛋白校正剂/增强剂后，临床及影像学表现均有改善，通过IOS测量的呼吸系统力学也有所改善。我们还报告了一项新发现：观察到低频时的电抗低于高频时的预期值（“电抗反转”）。
电抗反转可能反映了CF患儿存在的阻力和弹性方面的平行路径不均匀性或呼吸过程中气道惯性变化。对于因哮喘、囊性纤维化和婴儿慢性肺部疾病导致气道阻塞的儿童，还需要进一步研究以证实这一发现的普遍性以及它是否特定于某种测量设备。
