Application of Impulse Oscillometry in Respiratory System Evaluation in Elderly Patients

Tomalak, Waldemar; Czajkowska-Malinowska, Małgorzata; Radliński, Jakub

doi:10.5603/piap.2014.0041

Cited by 21 publications

(22 citation statements)

References 18 publications

(20 reference statements)

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“…COPD is characterized by the incomplete reversibility of airflow limitations; however, it is generally believed that FEV 1 is unable to fully evaluate pulmonary function, especially in cases of small airway dysfunction, while IOS can provide more detailed information on pulmonary function, especially on the assessment of peripheral airway conditions, which is the main location of COPD airflow limitation 3,13,14. In this study, FVC, FEV 1 , FEV 1 /FVC, and MMEF decreased in COPD patients compared with healthy controls, which reflected airflow limitations.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, it is easy to produce false-positive results because of the change in bronchomotor tone caused by repeated forced breathing, especially in the elderly. Thus, studies concerning the quality of spirometry in elderly patients showed that only slightly >30% of patients were able to perform spirometry that fulfilled all the quality criteria as defined by European Respiratory Society/American Thoracic Society standards,3,4 and the proportion in the advanced elderly was even lower 5. Furthermore, FEV 1 cannot fully assess lung function, particularly the identification of small airway abnormalities.…”

Section: Introductionmentioning

confidence: 99%

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Clinical application value of impulse oscillometry in geriatric patients with COPD

Liu

2017

COPD

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BackgroundThe diagnosis and assessment of COPD rely mainly on the use of spirometry, which is an effort-dependent test and requires good patient cooperation. Impulse oscillometry (IOS) is a non-volitional method that requires less effort and cooperation and presents advantages for geriatric patients. However, the clinical application value of IOS in geriatric patients with COPD remains unclear.AimThe aim of this study was to investigate the clinical application value of IOS in geriatric patients with COPD.Subjects and methodsA total of 234 subjects were retrospectively enrolled in this study, including 133 patients with COPD and 101 healthy volunteers. All the participants underwent IOS and spirometry examination. The data were collected and analyzed in the overall group, the geriatric group (aged ≥65 years), and the advanced elderly group (aged ≥80 years).Results1) In COPD patients, a significant increase in respiratory impedance (Z5), resonant frequency (Fres), and respiratory resistance (R5, R20, R5–R20) and a decrease in respiratory reactance (X5) were observed in the overall group, the geriatric group, and the advanced elderly group compared with the healthy control subjects. 2) The IOS parameters correlated well with spirometry in COPD. In particular, R5–R20 showed the best correlation with forced expiratory volume in 1 second (FEV1) in the different age groups. 3) Fres and R5–R20 had the best diagnostic efficiency for COPD. The area under the curve (AUC) values for Fres, expressed by the receiver operating characteristic (ROC) curve, were 0.905, 0.909, and 0.914, for the different age groups, respectively. 4) The optimal cutoff values for Fres to diagnose airflow obstruction from ROC curves was 17.715 in the COPD patients. Its sensitivity and specificity were 0.789 and 0.931, respectively, and the cutoff values were similar in geriatric and advanced elderly patients.ConclusionIOS demonstrated good relevance compared with spirometry for geriatric patients with COPD. IOS may serve as an alternative method for spirometry in elderly subjects for the evaluation of the state of COPD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical application value of impulse oscillometry in geriatric patients with COPD

Liu

2017

COPD

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“…Because FOT does not require the forced expiratory maneuvers needed to generate spirometry data, it can be performed easily in pediatric patients3,4 and adults who are unable to perform spirometry 2,5. It has been reported that FOT measurements may be more sensitive than forced expiratory volume in 1 second (FEV 1 ) for measuring the effects of bronchodilator drugs in patients with COPD and asthma 6–8.…”

Section: Introductionmentioning

confidence: 99%

Use of the forced-oscillation technique to estimate spirometry values

Yamamoto¹,

Miyoshi²,

Katayama³

et al. 2017

COPD

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PurposeSpirometry is sometimes difficult to perform in elderly patients and in those with severe respiratory distress. The forced-oscillation technique (FOT) is a simple and noninvasive method of measuring respiratory impedance. The aim of this study was to determine if FOT data reflect spirometric indices.Patients and methodsPatients underwent both FOT and spirometry procedures prior to inclusion in development (n=1,089) and validation (n=552) studies. Multivariate linear regression analysis was performed to identify FOT parameters predictive of vital capacity (VC), forced VC (FVC), and forced expiratory volume in 1 second (FEV1). A regression equation was used to calculate estimated VC, FVC, and FEV1. We then determined whether the estimated data reflected spirometric indices. Agreement between actual and estimated spirometry data was assessed by Bland–Altman analysis.ResultsSignificant correlations were observed between actual and estimated VC, FVC, and FEV1 values (all r>0.8 and P<0.001). These results were deemed robust by a separate validation study (all r>0.8 and P<0.001). Bias between the actual data and estimated data for VC, FVC, and FEV1 in the development study was 0.007 L (95% limits of agreement [LOA] 0.907 and −0.893 L), −0.064 L (95% LOA 0.843 and −0.971 L), and −0.039 L (95% LOA 0.735 and −0.814 L), respectively. On the other hand, bias between the actual data and estimated data for VC, FVC, and FEV1 in the validation study was −0.201 L (95% LOA 0.62 and −1.022 L), −0.262 L (95% LOA 0.582 and −1.106 L), and −0.174 L (95% LOA 0.576 and −0.923 L), respectively, suggesting that the estimated data in the validation study did not have high accuracy.ConclusionFurther studies are needed to generate more accurate regression equations for spirometric indices based on FOT measurements.

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“…La oscilometría de impulso puede ser una alternativa a la espirometría y da información acerca de las propiedades de resistencia del sistema respiratorio. Esto se evaluó en un estudio que tomó 277 informes de oscilometría de impulso en pacientes entre 65 a 96 años y los comparó con la espirometría, para encontrar que las resistencias medidas con oscilometría de impulso (R5, R5-R20) y frecuencia de resonancia (Fres) se correlacionaron de manera significativa con el VEF 1 , considerando que la oscilometría de impulso puede servir como un método complementario o alternativo a la espirometría para la evaluación del estado del sistema respiratorio (1). No tiene ninguna contraindicación excepto aquellas alteraciones anatómicas que no permitan realizar una respiración o volumen corriente.…”

Section: Introductionunclassified

“…It has been used for early assessment of respiratory system impedance in asthma and chronic obstructive pulmonary disease, interstitial lung diseases, mechanical pulmonary changes in patients (1) Medicina Interna, Fellow de Neumología. Hospital Santa Clara.…”

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confidence: 99%

Oscilometría de impulso en adultos: una prueba de función pulmonar complementaria

Santos¹,

Hincapié

Ordóñez³

et al. 2014

rev. colomb. neumol.

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La oscilometría de impulso es una prueba no invasiva que se ha retomado recientemente para determinar la impedancia del sistema respiratorio, principalmente en aquellos pacientes que tengan compromiso de la vía aérea pequeña y cuando no se pueda realizar un esfuerzo adecuado o maniobras convencionales. Puede servir como un método complementario o alternativo a la espirometría en la evaluación del estado del sistema respiratorio. Fue desarrollada desde 1956 pero solo hasta 2007 se incluyó en las guías ATS/ERS para la evaluación de la función pulmonar en preescolares. Consiste en la medición del impedimento natural al flujo de aire, lo cual incluye pérdidas friccionales y cargas elásticas e inerciales. Mide las resistencias centrales (R20) y las resistencias totales (R5), así como el delta de resistencia (ΔR=R5-R20), la reactancia capacitiva distal (X5), la frecuencia de resonancia (Fres) y el área de reactancia (AX). Tiene unos criterios de aceptabilidad que deben cumplirse y se sugiere que la interpretación se realice de manera sistemática. Los valores comparativos para su interpretación se han tomado de diferentes ecuaciones de acuerdo con edad, sexo, raza, altura y peso.Se ha utilizado para evaluar de forma temprana la impedancia del sistema respiratorio en asma y enfermedad pulmonar obstructiva crónica, enfermedades pulmonares intersticiales, cambios pulmonares mecánicos en pacientes con insuficiencia cardíaca congestiva, obstrucción de la vía aérea superior, disfunción de cuerdas vocales, como alternativa para la realización de test de broncoprovocación, como herramienta de evaluación complementaria en el manejo de pacientes con enfermedad pulmonar obstructiva crónica, respuesta a broncodilatadores, cambios en la resistencia de la vía aérea en pacientes con síndrome de apnea/hipopnea obstructiva del sueño, resistencias respiratorias en pacientes con lesión en la médula espinal, entre otras aplicaciones.Sin embargo, se requieren más estudios de calidad apropiada para determinar la utilidad de esta prueba diagnóstica en la práctica clínica.

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Application of Impulse Oscillometry in Respiratory System Evaluation in Elderly Patients

Abstract: As R5-R20 is regarded as a measure of peripheral airways resistance, IOS may serve as an interesting complementary or alternative method for spirometry in elderly subjects for evaluation of the state of respiratory system.

Cited by 21 publications

References 18 publications

Clinical application value of impulse oscillometry in geriatric patients with COPD

Clinical application value of impulse oscillometry in geriatric patients with COPD

Use of the forced-oscillation technique to estimate spirometry values

Oscilometría de impulso en adultos: una prueba de función pulmonar complementaria

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