Stanley P Galant

Title : Why assessing the peripheral airways (PAW) by oscillometry (OS) should be part of standard pulmonary function testing in asthmatic children

Abstract:

This presentation will have three phases.  
Phase I will be an overview of the peripheral airways and oscillometry testing.  This will include the importance of the peripheral airways in asthma, methods of assessing the peripheral airways with different types of oscillometers, what to expect from the oscillometry report, advantages of oscillometry versus spirometry, limitations of oscillometry, and the clinical effectiveness of extra fine inhaled corticosteroids which target the peripheral airways versus non-extra fine inhaled corticosteroids.” The case for impulse oscillometry in management of asthma in children and adults” (2017) (1)

Phase II will include our studies from 2012 to 2022.  

• Relationship of small airways to asthma control by using impulse oscillometry in children (2012).  (2)
• Peripheral airway impairment (PAI) measured by oscillometry predicts loss of asthma control in children (2013).  (3)
• Standardized impulse oscillometry reference values define peripheral impairment associated with uncontrolled asthma across ethnicity in children (2020).  (4)
• Peripheral airway impairment and dysanapsis define the risk of uncontrolled asthma in obese asthmatic children (2022).  (5)
• In young children, obesity and uncontrolled asthma are highly associated with peripheral airway impairment 2022 submitted.  (6)

Phase III. This will include conclusions, the need for future research, and references. 

It is our goal to present evidence that the status of the peripheral airways is critical for optimal diagnosis and management of asthma, and that oscillometry is the best practice, office, method of establishing the presence of peripheral airway impairment, which is highly associated with uncontrolled asthma. Utilizing oscillometry, a simple tool to use, particularly in young children, will help the clinician better identify asthma, and uncontrolled asthma, predict loss of asthma control, and better understand the abnormal lung mechanics that offer an explanation for the poor asthma outcomes, particularly in the obese asthmatic child.  In addition, this presentation will make clear that asthmatic children at high risk for peripheral airway impairment are those that are young, obese, and have uncontrolled asthma that can be inferred when oscillometry is not available. Finally, identifying peripheral airway impairment, which is a treatable trait, may result in better asthma outcomes such as asthma control with the use of extra fine inhaled corticosteroids that can reach the peripheral airways, particularly in those with difficulty controlling asthma.  

Audience Take Away Notes:

• It is our goal to present evidence that the status of the peripheral airways is critical for optimal diagnosis and management of asthma, and that oscillometry is the best practical.
• In office, method of establishing the presence of peripheral airway impairment, which is highly associated with uncontrolled asthma.

Biography:

Stanley P. Galant, MD graduated from the University of California School of Medicine in San Francisco in 1963, after attending the University of California, Berkeley for his undergraduate studies. He then served his internship at LA Children's Hospital and his Pediatric Residency at UC San Francisco. From 1966-1968 he served as Pediatrician and Captain in the US Army. Following his tour of duty, he returned to UC San Francisco for his Fellowship training in Allergy and Immunology 1968-1970.  He is currently Clinical Professor of Pediatrics at UCI and has served as the Medical Director of the CHOC Children’s Breathmobile, a program which provides care for underserved asthmatic children. He has published over 150 papers in peer review journals. For almost 50 years he has mentored allergy immunology fellows, and pediatric residents at several academic institutions. He was recently acknowledged by the American Academy of Allergy & Immunology as the 2019 AAAAI Outstanding Volunteer Clinical Faculty Award recipient.