Role of Impulse Oscillometry in Children with Airway Narrowing After
Bronchoscopic Stent Implantation, a Pilot Observational Study
Abstract
Introduction: Airway stent implantation may alleviate respiratory
difficulties in pediatric patients with airway narrowing, yet its
physiological changes in pulmonary function tests remain unknown. Our
objective is to determine the aerodynamic changes after stent
implantation by spirometry and impulse oscillometry in children with
airway stent implantation. Methods: A retrospective chart review was
conducted at China Medical University Children’s Hospital, Taichung,
Taiwan between January 2019 and October 2022. Results: Four adolescents
with successful stent implantation received impulse oscillometry
examination (IOS) before and after BONA stent implantation. The results
showed no significant reduction in total airway resistance (R5)
(1.66±0.44 vs. 1.25±0.21, P = 0.10) or central airway resistance (R20)
(0.74±0.21 vs. 0.70±0.11, P = 0.63). However, there was significant
improvement in small airway resistance (0.92±0.36 vs. 0.56±0.27, P =
0.04) after stent implantation. Meanwhile, all patients had a positive
bronchodilator test response in impulse oscillometry before and after
stent implantation. Inhaled corticosteroids with long-acting beta-2
agonists were given to all four patients after stent implantation.
Conclusions: IOS could be used as a non-invasive tool for monitoring
pulmonary function after airway stent implantation. Peripheral airway
resistance, but not total or central airway resistance, may be improved
after airway stent implantation. However, chronic airway inflammation
may remain and require long-term inhaled steroid with bronchodilator
treatment.