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Pediatric Pulmonology Nov 2023The European Respiratory Society Oscillometry Taskforce identified that clinical correlates of bronchodilator responses are needed to advance oscillometry in clinical...
INTRODUCTION
The European Respiratory Society Oscillometry Taskforce identified that clinical correlates of bronchodilator responses are needed to advance oscillometry in clinical practice. The understanding of bronchodilator-induced oscillometry changes in preterm lung disease is poor. Here we describe a comparison of bronchodilator assessments performed using oscillometry and spirometry in a population born very preterm and explore the relationship between bronchodilator-induced changes in respiratory function and clinical outcomes.
METHODS
Participants aged 6-23 born ≤32 (N = 288; 132 with bronchopulmonary dysplasia) and ≥37 weeks' gestation (N = 76, term-born controls) performed spirometry and oscillometry. A significant bronchodilator response (BDR) to 400 μg salbutamol was classified according to published criteria.
RESULTS
A BDR was identified in 30.9% (n = 85) of preterm-born individuals via spirometry and/or oscillometry, with poor agreement between spirometry and oscillometry definitions (k = 0.26; 95% confidence interval [CI] 0.18-0.40, p < .001). Those born preterm with a BDR by oscillometry but not spirometry had increased wheeze (33% vs. 11%, p = .010) and baseline resistance (Rrs z-score mean difference (MD) = 0.86, 95% CI 0.07-1.65, p = .025), but similar baseline spirometry to the group without a BDR (forced expiratory volume in 1 s [FEV ] z-score MD = -0.01, 95% CI -0.66 to 0.68, p > .999). Oscillometry was more feasible than spirometry (95% success rate vs. 85% (FEV ), 69% (forced vital capacity) success rate, p < .001), however being born preterm did not affect test feasibility.
CONCLUSION
In the preterm population, oscillometry is a feasible and clinically useful supportive test to assess the airway response to inhaled salbutamol. Changes measured by oscillometry reflect related but distinct physiological changes to those measured by spirometry, and thus these tests should not be used interchangeably.
Topics: Infant, Newborn; Humans; Child; Young Adult; Bronchodilator Agents; Oscillometry; Spirometry; Respiratory Function Tests; Forced Expiratory Volume; Albuterol; Lung
PubMed: 37539845
DOI: 10.1002/ppul.26632 -
Cold Spring Harbor Perspectives in... Nov 2019During the detection of sound, hair bundles perform a crucial step by responding to mechanical deflections and converting them into changes in electrical potential that... (Review)
Review
During the detection of sound, hair bundles perform a crucial step by responding to mechanical deflections and converting them into changes in electrical potential that subsequently lead to the release of neurotransmitter. The sensory hair bundle response is characterized by an essential nonlinearity and an energy-consuming amplification of the incoming sound. The active response has been shown to enhance the hair bundle's sensitivity and frequency selectivity of detection. The biological phenomena shown by the bundle have been extensively studied in vitro, allowing comparisons to behaviors observed in vivo. The experimental observations have been well explained by numerical simulations, which describe the cellular mechanisms operant within the bundle, as well as by more sparse theoretical models, based on dynamical systems theory.
Topics: Animals; Compressive Strength; Hair Cells, Auditory; Hearing; Humans; In Vitro Techniques; Mechanotransduction, Cellular; Models, Biological; Movement; Nonlinear Dynamics; Oscillometry
PubMed: 30323015
DOI: 10.1101/cshperspect.a035014 -
Oscillometry in Lung Function Assessment: A Comprehensive Review of Current Insights and Challenges.Cureus Oct 2023Oscillometry, a non-invasive technique for assessing lung function, has gained significant recognition and importance in modern pulmonary medicine. This comprehensive... (Review)
Review
Oscillometry, a non-invasive technique for assessing lung function, has gained significant recognition and importance in modern pulmonary medicine. This comprehensive review thoroughly explores its principles, applications, advantages, limitations, recent innovations, and future directions. Oscillometry's primary strength lies in its ability to offer a holistic assessment of lung mechanics. Unlike traditional spirometry, oscillometry captures the natural airflow during quiet breathing, making it suitable for patients of all ages and those with severe respiratory conditions. It provides a comprehensive evaluation of airway resistance, reactance, and compliance, offering insights into lung function that were previously challenging to obtain. In clinical practice, oscillometry finds extensive application in diagnosing and managing respiratory diseases. It plays a pivotal role in asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases. By detecting subtle changes in lung function before symptoms manifest, oscillometry facilitates early interventions, improving disease management and patient outcomes. Oscillometry's non-invasive and patient-friendly nature is precious in pediatric care, where traditional spirometry may be challenging for young patients. It aids in diagnosing and monitoring pediatric respiratory disorders, ensuring that children receive the care they need from an early age. Despite its many advantages, oscillometry faces challenges, such as the need for standardized protocols and the complexity of data interpretation. However, ongoing efforts to establish global standards and provide education and training for healthcare professionals aim to address these issues. Looking ahead, oscillometry holds great promise in the field of personalized medicine. With its ability to tailor treatment plans based on individualized lung function data, healthcare providers can optimize therapy selection and dosing, ultimately improving patient care and quality of life. In conclusion, oscillometry is poised to play an increasingly pivotal role in modern pulmonary medicine. As standardization efforts continue and technology evolves, it is an indispensable tool in the clinician's arsenal for diagnosing, managing, and personalizing respiratory care, ultimately leading to improved patient outcomes and better respiratory health.
PubMed: 38034137
DOI: 10.7759/cureus.47935 -
Pediatric Pulmonology Jul 2022Spirometry plays an important role in the assessment of possible respiratory failure in children with neuromuscular diseases (NMDs). However, obtaining reliable...
INTRODUCTION
Spirometry plays an important role in the assessment of possible respiratory failure in children with neuromuscular diseases (NMDs). However, obtaining reliable spirometry results is a major challenge. We studied the relation between oscillometry and spirometry results. Oscillometry is an easy, noninvasive method to measure respiratory resistance R and reactance X. We hypothesized an increased R and reduced X in patients with more reduced lung function.
METHODS
In this prospective single-center study, we included all children with NMDs able to perform spirometry. We consecutively measured R and X at 5, 11, and 19 Hz and (forced) vital capacity, peak expiratory flow. Spearman correlation coefficients and positive and negative predictive values were calculated. Regression curves were estimated.
RESULTS
We included 148 patients, median age 13 years (interquartile range: 8-16). A negative correlation was found between R and spirometry outcomes (Spearman correlation coefficient [ρ]: -0.5 to -0.6, p < 0.001). A positive correlation was found between X (i.e., less negative outcomes) and spirometry outcomes (ρ: 0.4-0.6, p < 0.001). Highest correlation was found at lower frequencies. Regression analysis showed a nonlinear relation. Measurement of inspiratory and expiratory R and X did not provide added value. Positive predictive values of 80%-85% were found for z-scores of R measured at 5 Hz versus (F)VC ≤ 60%.
CONCLUSION
We found a nonlinear relation between oscillometry and spirometry results with increased R and reduced X in patients with more restrictive lung function decline. Given the difficulties with performing spirometry, oscillometry may be a promising substitute.
Topics: Adolescent; Child; Forced Expiratory Volume; Humans; Lung; Neuromuscular Diseases; Oscillometry; Prospective Studies; Spirometry
PubMed: 35441830
DOI: 10.1002/ppul.25923 -
Jornal Brasileiro de Pneumologia :... 2022To compare impulse oscillometry parameters between healthy children and adolescents with symptoms of rhinitis and those without.
OBJECTIVE
To compare impulse oscillometry parameters between healthy children and adolescents with symptoms of rhinitis and those without.
METHODS
This was a cross-sectional analytical study of healthy individuals 7-14 years of age. Health status was determined through the use of questionnaires. We performed anthropometric measurements, impulse oscillometry, and spirometry.
RESULTS
The sample comprised 62 students, with a mean age of 9.58 ± 2.08 years and a mean body mass index (BMI) of 17.96 ± 3.10 kg/m2. The students were divided into two groups: those with symptoms of rhinitis (n = 29) and those without such symptoms (n = 33). The oscillometry results and anthropometric parameters were normal in both groups and did not differ significantly between the two. The variables age, height, and body mass, respectively, correlated negatively and moderately with most of the following parameters: total airway resistance (r = -0.529, r = -0.548, and r = -0.433); central airway resistance (r = -0.441, r = -0.468, and r = -0.439); respiratory impedance (r = -0.549, r = -0.567, and r = -0.455); reactance at 5 Hz (r = 0.506, r = -0.525, and r = -0.414); reactance area (r = -0.459, r = -0.471, and r = -0.358); and resonance frequency (r = -0.353, r = -0.371, and r = -0.293). We found that BMI did not correlate significantly with any of the parameters evaluated. The same was true when we analyzed each group in isolation.
CONCLUSIONS
In our sample, impulse oscillometry parameters did not differ between the students who had symptoms of rhinitis and those who did not.
Topics: Adolescent; Child; Cross-Sectional Studies; Humans; Oscillometry; Respiratory Function Tests; Rhinitis; Spirometry
PubMed: 35857937
DOI: 10.36416/1806-3756/e20190021 -
Sarcoidosis, Vasculitis, and Diffuse... 2021Sarcoidosis is a systemic inflammatory granulomatous disease which commonly affects intrathoracic lymph nodes, lung parenchyma and airways.
BACKGROUND
Sarcoidosis is a systemic inflammatory granulomatous disease which commonly affects intrathoracic lymph nodes, lung parenchyma and airways.
OBJECTIVES
To measure respiratory impedance using Impulse Oscillometry (IOS) in patients with pulmonary sarcoidosis and compare the parameters with healthy controls.
METHODS
Patients diagnosed with sarcoidosis (n=28); and age and gender matched healthy controls (n=17) were recruited. Lung volumes and capacities were measured by spirometry and respiratory system impedance was assessed using Impulse Oscillometry System (IOS). Measurements were performed before and 15 minutes after inhalation of a short acting bronchodilator. The IOS and spirometric parameters were compared between two groups and correlated. ROC curve analysis was also performed to identify the IOS parameters which can discriminate between sarcoidosis and healthy controls.
RESULTS
Resistance at 5 and 20 Hz (R5 and R20), small airway resistance (R5-R20), resonant frequency (F) and area of reactance (AX) were significantly higher in Sarcoidosis subjects compared with controls. Reactance at 5 and 20 Hz (X5 and X20) were significantly lower in sarcoidosis. FEV (% predicted) and FVC (% predicted) were significantly lower in patients with sarcoidosis while FEV/FVC ratio and peak expiratory flow rate (PEF) values were comparable. Post bronchodilator inhalation, there was improvement in airway resistance and reactance, but no significant changes observed in spirometric parameters. R5, X5 and R5-R20 are promising parameters to discriminate sarcoidosis from healthy controls.
CONCLUSION
Increased airway resistance is a better indicator of airway involvement than airflow limitation by spirometry in pulmonary sarcoidosis.
PubMed: 34744428
DOI: 10.36141/svdld.v38i3.8674 -
The Journal of Asthma : Official... Jun 2023Lung function testing is used in diagnosing asthma and assessing asthma control. Spirometry is most commonly used, but younger children can find performing this test...
OBJECTIVE
Lung function testing is used in diagnosing asthma and assessing asthma control. Spirometry is most commonly used, but younger children can find performing this test challenging. Non-volitional tests such as airwave oscillometry (AOS) may be helpful in that population. We compared the success of spirometry and AOS in assessing bronchodilator responsiveness in children.
METHODS
AOS was conducted alongside routine lung function testing. Resistance at 5 Hz (R5), the difference between the resistance at 5 and 20 Hz (R5-20) and the area under the reactance curve (AX) were assessed. Patients between 5 and 16 years old attending clinic with wheeze or asthma were assessed. Patients performed AOS, followed by spirometry and were then given 400 µg salbutamol; the tests were repeated 15 minutes later.
RESULTS
Lung function testing was performed in 47 children of whom 46 (98%) and 32 (68%) performed acceptable baseline oscillometry and spirometry, respectively ( < 0.001). Children unable to perform acceptable spirometry were younger (7.35, range: 5.4-10.3 years) than those who could (10.4, range: 5.5-16.9 years), < 0.001. The baseline z-scores of AOS R5 correlated with FEV ( = 0.499, = 0.004), FEF ( = 0.617, < 0.001), and FEV/FVC ( = 0.618, < 0.001). There was a positive bronchodilator response assessed by spirometry (change in FEV ≥ 12%) in eight children which corresponded to a change in R5 of 36% (range: 30%-50%) and a change in X5 of 39% (range: 15%-54%).
CONCLUSIONS
Oscillometry is a useful adjunct to spirometry in assessing young asthmatic children's lung function. The degree of airway obstruction, however, might affect the comparability of the results of the two techniques.
Topics: Humans; Child; Child, Preschool; Adolescent; Asthma; Bronchodilator Agents; Oscillometry; Forced Expiratory Volume; Spirometry
PubMed: 36218195
DOI: 10.1080/02770903.2022.2134795 -
The European Respiratory Journal Sep 2020
Topics: Early Diagnosis; Humans; Oscillometry; Physical Therapy Modalities; Pulmonary Disease, Chronic Obstructive
PubMed: 32912925
DOI: 10.1183/13993003.01815-2020 -
ERJ Open Research Oct 2022Respiratory oscillometry is a promising complement to the traditional pulmonary function tests for its simplicity. The usefulness of oscillometry in adult clinical...
BACKGROUND
Respiratory oscillometry is a promising complement to the traditional pulmonary function tests for its simplicity. The usefulness of oscillometry in adult clinical practice has not been clarified. This study aimed to analyse the characteristics and diagnostic performance of oscillometry in respiratory diseases, and explore the cut-offs of oscillometric parameters for severity grading.
METHODS
In this multicentre registry of impulse oscillometry (IOS), IOS and spirometric data of healthy individuals and patients with respiratory diseases were collected and analysed. Linear mixed model analysis was performed to explore the effects of disease and forced expiratory volume in 1 s (FEV) on oscillometric parameters.
RESULTS
The study included 567 healthy subjects, 781 asthmatic patients, 688 patients with chronic obstructive pulmonary disease (COPD), 109 patients with bronchiectasis, 40 patients with upper airway obstruction (UAO) and 274 patients with interstitial lung disease (ILD) in the analysis. Compared at the same FEV level, asthma, COPD, bronchiectasis, UAO and ILD displayed different oscillometric characteristics. The z-score of resistance at 5 Hz ( ) was the best variable to identify respiratory diseases with a sensitivity of 62.4-66.7% and a specificity of 81.5-90.3%. With reference to the severity grading cut-offs of FEV, z-scores of 2.5 and 4 were defined as the cut-off values of moderately and severely increased .
CONCLUSION
Respiratory oscillometry is more appropriate to be a tool of evaluating, rather than of diagnosing, respiratory diseases. A severity grading system of oscillometric parameters was developed to help the interpretation of oscillometry in clinical practice.
PubMed: 36267898
DOI: 10.1183/23120541.00080-2022 -
The World Allergy Organization Journal Jan 2023Asthma imposes a heavy morbidity burden during childhood; it affects over 10% of children in Europe and North America and it is estimated to exceed 400 million people... (Review)
Review
Asthma imposes a heavy morbidity burden during childhood; it affects over 10% of children in Europe and North America and it is estimated to exceed 400 million people worldwide by the year 2025. In clinical practice, diagnosis of asthma in children is mostly based on clinical criteria; nevertheless, assessment of both physiological and pathological processes through biomarkers, support asthma diagnosis, aid monitoring, and further lead to better treatment outcomes and reduced morbidity. Recently, identification and validation of biomarkers in pediatric asthma has emerged as a top priority across leading experts, researchers, and clinicians. Moreover, the implementation of non-invasive biomarkers for the assessment and monitoring of paediatric patients with asthma, has been prioritized; however, only a proportion of them are currently included in the clinical practise. Although, the use of non-invasive biomarkers is highly supported in recent asthma guidelines for documenting diagnosis and supporting monitoring of asthmatic patients, data on the Pediatric population are limited. In the present report, the Pediatric Asthma Committee of the World Allergy Organization (WAO), aims to summarize and discuss available data for the implementation of non-invasive biomarkers in the diagnosis and monitoring in children with asthma. Information on the most studied biomarkers, including spirometry, oscillometry, markers of allergic sensitization, fractional exhaled nitric oxide, and the most recent exhaled breath markers and "omic" approaches, will be reviewed. Practical limitations and considerations based on both experts' opinion and critical review of the literature, on the utility of all "well-known" and newly introduced non-invasive biomarkers will be presented. A critical commentary on biomarkers' use in diagnosing and monitoring asthma during the COVID-19 pandemic, cost and availability of biomarkers in different settings and in developing countries, the differences on the biomarkers use between Primary Practitioners, Pediatricians, and Specialists and their role on the longitudinal aspect of asthma is provided.
PubMed: 36601259
DOI: 10.1016/j.waojou.2022.100727