# The Role of IOS in Identification of Specific Treatable Traits in Pediatric Asthma: Current Limitations and Future Perspectives—Narrative Review

## TL;DR

This review discusses how impulse oscillometry (IOS) can help identify treatable traits in pediatric asthma, but more research is needed to integrate it into routine care.

## Contribution

The paper highlights the potential of IOS for identifying small airway disease in children with asthma and suggests future research directions.

## Key findings

- IOS is a suitable method for evaluating lung function in children with asthma.
- Establishing population-specific reference values for IOS is necessary before routine clinical use.
- Combining IOS with spirometry and FeNO may improve asthma trait identification.

## Abstract

Asthma management in children aims to prevent ongoing symptoms, preserve lung function and support normal daily activities. Impulse oscillometry (IOS) represents a modern approach to evaluating lung function that is also suitable for performing in the pediatric asthma population. Further research is warranted to clarify the role of IOS in the early identification of small airway disease (SAD) as a potential treatable asthma trait and to understand its implications for personalized treatment strategies. Before the integration of IOS into routine clinical protocols, it is necessary to establish population-specific reference values. Further studies in the pediatric population are needed to evaluate the added value of IOS in combination with conventional spirometry and fractional exhaled nitric oxide (FeNO). Future pediatric asthma management guidelines may consider incorporating the assessment of SAD with IOS as a possible tool for its evaluation.