Comparative Evaluation of Clinical, Spiro/Oscillometric and Tomographic Parameters As A Global Assessment of Children With Cystic Fibrosis

Abstract

Background: The aim of our study was to compare clinical severity scores and classic spirometry with impulse oscillometry (IOS) results and thoracic high-resolution computed tomography (HRCT) scores in children with CF in order to determine the utility of the latter approach in patient follow-up Methods: CF patients over 6 years of age were included. Swachman score, classical spirometri and IOS were performed when not in acute exacerbation. Thoracic HRCT images obtained within the previous 3 months were evaluated using the Bhalla scoring system Results: Pseudomonas aeruginosa was isolated from sputum cultures of 40% of the patients. Patients with FEV1 below 80% exhibited significantly higher (resistance)R5, R10 values and significantly lower (reactance) X5 values on IOS (p=0.03, 0.027, 0.006, respectively). Patients with P.aeruginosa had significantly lower FEV1, FVC, and FEF25-75 values in classic spirometry when compared with patients without P.aeruginosa (p=0.002, p=0.002, and p=0.005, respectively). P. aeruginosa-positive patients showed significantly higher R5 and lower X5 values (p=0.047, 0.046, respectively). Bhalla scoring system was higher and Shwachman scores lower in P. aeruginosa-positive group (p Conclusion: IOS and tomographic scoring can be used safely in early detection of impairment in lung function. Further studies are needed to evaluate the utility of IOS in the clinical monitoring of children with CF who are not compliant with spirometry maneuvers.