NEUMOLOGÍA PEDIÁTRICA

Neumol Pediatr 2021; 16 (1): 5 - 10 C o n t e n i d o d i s p o n i b l e e n h t t p : / / www. n e umo l o g i a - p e d i a t r i c a . c l 11 Técnica de oscilações forçadas na avaliação e manejo de crianças asmáticas: uma revisão narrativa Forced oscillation technique in the ssessment and management of asthmatic child n Neumol Pediatr 2021; 16 (1): 11 6 INTRODUCTION Asthma is the chronical disease with most inciden- ce among children (1). The symptoms are frequently presen- ted within the first years of life and the diagnosis is based on each patient’s clinical history (2). The measurements of pulmonary function are an important part of asthma evalua- tion, since they help build a diagnosis through the analysis of bronchial reversibility and detect poor prognosis in disease control (1). Spirometry is the main method used to document characterized alterations of pulmonary function in asthma patients. However, its accuracy can be compromised regar- ding children, since acceptability and reproducibility of the exam both depend on focus and prolonged effort (3). Another diagnostic method to characterize the functional alterations of asthma include the airway resistance measures, which can be obtained through oscillometry, light switch technique and plethysmography (4). Oscillometry is considered a modern tool that allows for the measurement of the respiratory system's impedance (Z rs ). A Z rs includes all the forces that oppose the movement of air, being composed by resistance (R rs , frictional forces) and reactance (X rs , elastic and inertial forces). These components of Z rs can be calculated by mathematical transformations of the relation between pressure and flow in the frequency’s do- main (5). The Forced oscillations technique (FOT) allows for the evaluation of Z rs through R rs and X rs , from a tidal volume respiratory maneuver (6). The advantage of this noninvasive pathway of analysis makes this an appropriate method parti- cularly for poorly cooperative patients and, therefore, an im- portant element regarding pulmonary evaluation in children (7). Although there are differences among the measu- rement processes, spirometry and FOT are methods which present complementary and non-interchangeable information (3). By observing the FOT results it becomes clear that more studies are needed to clarify unprecedented results contribu- ting with the diagnostics in pneumology. That being said, the objective of this study was to review the clinical utility of this method in the pulmonary evaluation of children with asthma. METHODOLOGY This study consists of a narrative literature review, built up from 4 steps: the establishment of the time period to be studied, the choosing of a database to be analyzed, the characterization of the keywords that were used and the selection of relevant studies. The inclusion criteria were the following: studies from 1950 to 2019, with a sample population between 3 and 18 years of age, asthma sufferers and that used oscillometry as a form of evaluation. The bibliographical search was done between No- vember of 2019 and January of 2020, in the following da- tabases: Medical Literature Analysis and Retrieval System Online (MEDLINE) and Latin-American and Caribbean Health Science Literature (LILACS) . The following Mesh terms were used as search parameters: “asthma”, “oscillometry” and “child” crossed using the AND and OR Boolean connectors. The articles included in this review were summari- zed by author, equipment used in the evaluation, sample, ob- jective and main results. Briefly described in table 1 for an effortless visualization of each selected work. This study excludes narrative review studies, inte- grative, systematic and meta-analysis and operational direc- tives. As to the ethical aspects, an ethics committee sub- mission was not required since the data utilized was from articles indexed in databases. The flowchart 1 presents the methodological criteria. ARTÍCULOS DE REVISIÓN / REVIEW ARTICLES FORCED OSCILLATION TECHNIQUE IN THE ASSESSMENT AND MANAGEMENT OF ASTHMATIC CHILDREN: A NARRATIVE REVIEW Figure 1. Methodologic flowchart. Correspondence author: Marcos Brum A., Endereço: Av. Ipiranga, 6681 - Partenon - Porto Alegre/ RS – 90610-000, E-mail: marcos.antunes@edu.pucrs.br, Contato: 55 51 33203000, ramal 2221.