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Current Opinion in Pulmonary Medicine May 2024Oscillometry is a noninvasive pulmonary function test that has gained significant interest in the evaluation of lung disease. Currently, oscillometry is primarily a... (Review)
Review
PURPOSE OF REVIEW
Oscillometry is a noninvasive pulmonary function test that has gained significant interest in the evaluation of lung disease. Currently, oscillometry is primarily a research tool, but there is a growing body of evidence supporting its clinical use. This review describes the recent work evaluating the role of oscillometry in the diagnosis and treatment of asthma.
RECENT FINDINGS
A large body of observational data supports the ability of oscillometry to distinguish healthy individuals from those with respiratory symptoms or lung disease. Oscillometry may not be as useful as an isolated diagnostic test in asthma, but the combination with other pulmonary function tests may improve its diagnostic ability. Oscillometry can detect peripheral airways dysfunction in asthma, which is associated with symptoms and the risk for exacerbations. To help guide future research, minimal clinically important differences for specific oscillometry variables have been developed. Oscillometry may be useful in monitoring the response to biological therapy and has potential for personalizing treatment for individual patients. Oscillometry also has potential in uncovering unique aspects of the pathophysiology of asthma in obesity.
SUMMARY
Oscillometry is a promising tool in the diagnosis and management of asthma. More research is needed to support its routine clinical use.
Topics: Humans; Lung; Oscillometry; Spirometry; Asthma; Lung Diseases
PubMed: 38411171
DOI: 10.1097/MCP.0000000000001057 -
Respiratory Physiology & Neurobiology Oct 2023Oscillometry has been around for almost 70 years, but there are still many unknowns. The test is performed during tidal breathing and is therefore free from... (Review)
Review
Oscillometry has been around for almost 70 years, but there are still many unknowns. The test is performed during tidal breathing and is therefore free from patient-dependent factors that could influence the results. The Forced Oscillation Technique (FOT), which requires minimal patient cooperation, is gaining ground, particularly with elderly patients and children. In pulmonology, it is a valuable tool for assessing obstructive conditions (with a distinction between central and peripheral obstruction) and restrictive disorders (intrapulmonary and extrapulmonary). Its sensitivity allows the assessment of bronchodilator and bronchoconstrictor responses. Different lung diseases show different patterns of changes in FOT, especially studied in asthma and chronic obstructive pulmonary disease. Because of these differences, many studies have analysed the usefulness of this technique in different areas of medicine. In this paper, the authors would like to present the basics of oscillometry with the areas of its most recent clinical applications.
Topics: Child; Humans; Aged; Airway Resistance; Oscillometry; Asthma; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Spirometry; Forced Expiratory Volume
PubMed: 37536553
DOI: 10.1016/j.resp.2023.104135 -
Current Hypertension Reports Sep 2020To present the evidence that describes what is being measured by upper-arm cuff blood pressure (BP) and the level of accuracy compared with invasive central aortic and... (Review)
Review
PURPOSE OF REVIEW
To present the evidence that describes what is being measured by upper-arm cuff blood pressure (BP) and the level of accuracy compared with invasive central aortic and brachial BP. Potential causes of inaccuracy and emerging methods are also discussed.
RECENT FINDINGS
On average cuff systolic BP systematically underestimates invasive brachial systolic BP, although in a given individual it may substantially under- or over-estimate central aortic systolic BP. Such errors may affect individual health management outcomes and distort population level data on hypertension prevalence and control. Oscillometric cuff BP is particularly susceptible to inaccuracy in people with high arterial stiffness and with pathophysiological BP waveform shapes. Emerging cuff-less BP methods will be susceptible to inaccuracy if oscillometric cuff BP is used for calibration. The original purpose of cuff BP was to estimate central aortic BP. Recent evidence has shown substantial inaccuracy of oscillometric cuff BP exists for the measurement of invasive central aortic and brachial BP. Thus, development of more accurate BP methods, through better understanding of oscillometric and BP waveform morphology, is needed to improve health outcomes related to high BP.
Topics: Arterial Pressure; Blood Pressure; Blood Pressure Determination; Brachial Artery; Humans; Hypertension; Oscillometry
PubMed: 32959103
DOI: 10.1007/s11906-020-01103-8 -
American Journal of Physiology. Lung... Jun 2021Airway oscillometry has become the de facto standard for quality assessment of lung physiology in laboratory animals and has demonstrated its usefulness in understanding... (Review)
Review
Airway oscillometry has become the de facto standard for quality assessment of lung physiology in laboratory animals and has demonstrated its usefulness in understanding diseases of small airways. Nowadays, it is seeing extensive use in daily clinical practice and research; however, a question that remains unanswered is how well physiological findings in animals and humans correlate? Methodological and device differences are obvious between animal and human studies. However, all devices deliver an oscillated airflow test signal and output respiratory impedance. In addition, despite analysis differences, there are ways to interpret animal and human oscillometry data to allow suitable comparisons. The potential with oscillometry is its ability to reveal universal features of the respiratory system across species, making translational extrapolation likely to be predictive. This means that oscillometry can thus help determine if an animal model displays the same physiological characteristics as the human disease. Perhaps more importantly, it can also be useful to determine whether an intervention is effective as well as to understand if it affects the desired region of the respiratory system, e.g., the periphery of the lung. Finally, findings in humans can also inform preclinical scientists and give indications as to what type of physiological changes should be observed in animal models to make them relevant as models of human disease. The present article will attempt to demonstrate the potential of oscillometry in respiratory research, an area where the development of novel therapies is plagued with a failure rate higher than in other disease areas.
Topics: Animals; Asthma; Electric Impedance; Humans; Lung; Oscillometry; Respiratory Function Tests; Respiratory Physiological Phenomena
PubMed: 33822645
DOI: 10.1152/ajplung.00222.2020 -
Allergologia Et Immunopathologia 2022Asthma is one of the most common chronic diseases of childhood. Spirometry is the traditional test for assessing lung function, while impulse oscillometrics is an...
INTRODUCTION
Asthma is one of the most common chronic diseases of childhood. Spirometry is the traditional test for assessing lung function, while impulse oscillometrics is an alternative resource that measures the impedance of the respiratory system.
OBJECTIVE
To evaluate the pulmonary function of children and adolescents with asthma by impulse oscillometry and correlate the findings with those obtained by spirometry.
METHODS
A cross-sectional study in which the pulmonary function of asthmatic children and adolescents aged between 6 and 18 years was evaluated, categorized by the level of disease control according to the Asthma Control Test (ACT) or Children Asthma Control Test (C-ACT) into controlled (ACT/C-ACT>19; n = 70) and uncontrolled (ACT/C-ACT ≤ 19; n = 60).
RESULTS
A total of 130 asthmatic children and adolescents were evaluated (51% were males). There were no significant differences in the parameter values of both tests when patients were divided by the level of asthma control. Altered impulse oscillometry and spirometry were performed in 20 and 25% of the cases, respectively. Changes in impulse oscillometry were more frequent in patients with controlled asthma. R5 (%), X5 (%), and Fres showed moderate correlation with the main spirometric parameters, being stronger between X5 (%) and FEV/FVC (%) (r: -0,58; P < 0,05) in patients with controlled asthma. Bronchodilator response was observed in a similar number of patients in both exams, but with reasonable agreement.
CONCLUSIONS
Impulse oscillometry values showed a weak or moderate correlation with spirometry values.
Topics: Male; Humans; Child; Adolescent; Female; Oscillometry; Cross-Sectional Studies; Asthma; Spirometry; Lung; Forced Expiratory Volume
PubMed: 36545702
DOI: 10.15586/aei.v50iSP3.751 -
Journal of Visualized Experiments : JoVE Apr 2022Respiratory oscillometry is a different modality of pulmonary function testing that is increasingly used in a clinical and research setting to provide information...
Respiratory oscillometry is a different modality of pulmonary function testing that is increasingly used in a clinical and research setting to provide information regarding lung mechanics. Respiratory oscillometry is conducted through three acceptable measurements of tidal breathing and can be performed with minimal contraindications. Young children and patients who cannot perform spirometry due to cognitive or physical impairment can usually complete oscillometry. The main advantages of respiratory oscillometry are that it requires minimal patient cooperation and is more sensitive in detecting changes in small airways than conventional pulmonary function tests. Commercial devices are now available. Updated technical guidelines, standard operating protocols, and quality control/assurance guidelines have recently been published. Reference values are also available. We conducted oscillometry test audits before and after implementing a formal respiratory oscillometry training program and standard operating protocol. We observed improvement in the quality of tests completed, with a significant increase in the number of acceptable and reproducible measurements. The current paper outlines and demonstrates a standard operating protocol to conduct respiratory oscillometry in an outpatient setting. We highlight the key steps to ensuring acceptable and reproducible quality measurements according to the recommended European Respiratory Society (ERS) guidelines, as quality control is critical to measurement accuracies. Potential problems and pitfalls are also discussed with suggestions to resolve technical errors.
Topics: Child; Child, Preschool; Humans; Lung; Oscillometry; Outpatients; Respiratory Function Tests; Spirometry
PubMed: 35467649
DOI: 10.3791/63243 -
The Journal of Allergy and Clinical... May 2022Asthma is defined by the presence of reversible airflow limitation, yet persistently abnormal spirometry may develop despite appropriate asthma treatment. Fixed airflow...
BACKGROUND
Asthma is defined by the presence of reversible airflow limitation, yet persistently abnormal spirometry may develop despite appropriate asthma treatment. Fixed airflow obstruction (FAO) describes abnormal postbronchodilator spirometry that is associated with greater symptom burden and disease severity. Respiratory oscillometry measures the mechanics of the entire airway tree, including peripheral airway changes that have been shown to influence asthma symptoms.
OBJECTIVE
To evaluate the relationship between abnormal oscillometry following bronchodilator and symptom control in adults with asthma.
METHODS
A prospective cohort of patients with asthma attending an airways clinic completed oscillometry (resistance and reactance), spirometry, and the Asthma Control Test. Postbronchodilator lung function below the lower limit of normal was considered abnormal. Spirometric FAO was defined as FEV/forced vital capacity below the lower limit of normal. Spearman's rank coefficient and multiple linear regression were performed to assess associations of lung function parameters with Asthma Control Test. The discriminative ability of abnormal lung function to identify poor asthma control was determined using Cohen's kappa.
RESULTS
Ninety patients with asthma were included; 48% had spirometric FAO. Only reactance parameters, not spirometry, significantly related to (r ≥ 0.315; P < .05) and identified asthma control (r = 0.236; P < .001). Lung function was more strongly associated with asthma control in patients with FAO compared with those without. Abnormal oscillometry identified an additional 24% of patients with poor asthma control as compared with spirometric FAO.
CONCLUSIONS
Reactance related to asthma control, independently of spirometric FAO. Abnormal postbronchodilator reactance identified more patients with poor asthma control compared with spirometry. These findings confirm that oscillometry is a relevant lung function test in the clinical assessment of asthma.
Topics: Adult; Asthma; Forced Expiratory Volume; Humans; Lung; Oscillometry; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Spirometry
PubMed: 34979333
DOI: 10.1016/j.jaip.2021.12.026 -
American Journal of Respiratory and... Feb 2024Respiratory resistance (Rrs) and reactance (Xrs) as measured by oscillometry and their intrabreath changes have emerged as sensitive parameters for detecting early...
Respiratory resistance (Rrs) and reactance (Xrs) as measured by oscillometry and their intrabreath changes have emerged as sensitive parameters for detecting early pathological impairments during tidal breathing. This study evaluates the prevalence and association of abnormal oscillometry parameters with respiratory symptoms and respiratory diseases in a general adult population. A total of 7,560 subjects in the Austrian LEAD (Lung, hEart, sociAl, boDy) Study with oscillometry measurements (computed with the Resmon Pro FULL; Restech Srl) were included in this study. The presence of respiratory symptoms and doctor-diagnosed respiratory diseases was assessed using an interview-based questionnaire. Rrs and Xrs at 5 Hz, their inspiratory and expiratory components, the area above the Xrs curve, and the presence of tidal expiratory flow limitation were analyzed. Normality ranges for oscillometry parameters were defined. The overall prevalence of abnormal oscillometry parameters was 20%. The incidence of abnormal oscillometry increased in the presence of symptoms or diagnoses: 17% (16-18%) versus 27% (25-29%), < 0.0001. All abnormal oscillometry parameters except Rrs at 5 Hz were significantly associated with respiratory symptoms/diseases. Significant associations were found, even in subjects with normal spirometry, with abnormal oscillometry incidence rates increasing by 6% (4-8%; < 0.0001) in subjects with symptoms or diagnoses. Abnormal oscillometry parameters are present in one-fifth of this adult population and are significantly associated with respiratory symptoms and disease. Our findings underscore the potential of oscillometry as a tool for detecting and evaluating respiratory impairments, even in individuals with normal spirometry.
Topics: Adult; Humans; Oscillometry; Lung; Respiration; Exhalation; Respiratory Tract Diseases; Spirometry; Forced Expiratory Volume; Airway Resistance
PubMed: 37972230
DOI: 10.1164/rccm.202306-0975OC -
Hong Kong Medical Journal = Xianggang... Oct 2020
Topics: Blood Pressure Determination; History, 20th Century; Humans; Medical Illustration; Oscillometry; Sphygmomanometers
PubMed: 33089799
DOI: 10.12809/hkmj-hkmms202010 -
Medicina Clinica Jan 2020
Topics: Automation; Blood Pressure Determination; Humans; Oscillometry; Reference Standards; White Coat Hypertension
PubMed: 31196667
DOI: 10.1016/j.medcli.2019.04.009