Comparison of inspiratory and expiratory resistance and reactance in patients with asthma and chronic obstructive pulmonary disease

Paredi, Paolo; Goldman, Michael; Alamen, Almahdi; Ausín, Pilar; Usmani, Omar; Pride, N. B.; Barnes, Peter J.

doi:10.1136/thx.2009.120790

Cited by 125 publications

(106 citation statements)

References 15 publications

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“…Dynamic airway narrowing during quiet breathing at rest has been visually detected in a patient with severe COPD by high-speed electron-beam computed tomography (26). The EFL index is useful for the differentiation between COPD and asthma (12,14,29). In multivariate regression analyses, a high EFL index (more than 0.55 cmH2O/L/s measured with MostGraph) was independently predicted by the emphysema score, forced expiratory flow between 25% and 75% of FVC, functional residual capacity, and whole-breath R5 (30).…”

Section: Xrsmentioning

confidence: 99%

Clinical Application of the Forced Oscillation Technique

Shirai

Kurosawa

2016

Intern. Med.

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The forced oscillation technique (FOT) is a noninvasive method with which to measure respiratory system resistance and reactance during tidal breathing. Recently, its clinical application has spread worldwide with the expansion of commercially available broadband frequency FOT devices, including MostGraph and Impulse Oscillometry. An increasing number of reports have supported the usefulness of the FOT in the management of asthma and chronic obstructive pulmonary disease (COPD). However, the FOT is not a surrogate test for spirometry, but should be used complementarily. Furthermore, reference values are not necessarily available and the interpretation of some measured data is controversial. There is a need to update the international statement for not only technical aspects but also the clinical use of the FOT. In this review, we summarize the previously published studies and discuss how to use the FOT in a clinical setting.

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Section: Xrsmentioning

confidence: 99%

Clinical Application of the Forced Oscillation Technique

Shirai

Kurosawa

2016

Intern. Med.

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“…Using this technique, Paredi and colleagues have shown that while whole breath impulse oscillometry could not differentiate patients with asthma and COPD, patients with COPD had higher mean expiratory X5 than those with asthma, which they thought might be due to enhanced dynamic airway narrowing on expiration in these patients. 62 Another study has shown that in comparing FOT in patients with asthma and COPD, only patients with COPD show a significant difference in X RS between inspiration and expiration 63 ( Fig. 8).…”

Section: Measurement Of Airway Resistance By the Forced Oscillation Tmentioning

confidence: 99%

What Does Airway Resistance Tell Us About Lung Function?

2012

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SummarySpirometry is considered the primary method to detect the air flow limitation associated with obstructive lung disease. However, air flow limitation is the end-result of many factors that contribute to obstructive lung disease. One of these factors is increased airway resistance. Airway resistance is traditionally measured by relating air flow and driving pressure using body plethysmography, thus deriving airway resistance (R aw ), specific airway resistance (sR aw ), and specific airway conductance (sG aw ). Other methods to measure airway resistance include the forced oscillation technique (FOT), which allows calculation of respiratory system resistance (R RS ) and reactance (X RS ), and the interrupter technique, which allows calculation of interrupter resistance (R int ). An advantage of these other methods is that they may be easier to perform than spirometry, making them particularly suited to patients who cannot perform spirometry, such as young children, patients with neuromuscular disorders, or patients on mechanical ventilation. Since spirometry also requires a deep inhalation, which can alter airway resistance, these alternative methods may provide more sensitive measures of airway resistance. Furthermore, the FOT provides unique information about lung mechanics that is not available from analysis using spirometry, body plethysmography, or the interrupter technique. However, it is unclear whether any of these measures of airway resistance contribute clinically important information to the traditional measures derived from spirometry (FEV 1 , FVC, and FEV 1 /FVC). The purpose of this paper is to review the physiology and methodology of these measures of airway resistance, and then focus on their clinical utility in relation to each other and to spirometry.

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“…Although DFA of respiratory system impedance was not able to differentiate COPD from asthma or healthy control subjects, a distance-based time series analysis was able to distinguish asthma and COPD in the majority of cases (22). In moderate COPD, there are larger differences between inspiratory and expiratory FOT reactance compared with patients with asthma and healthy control subjects (74), and this difference is more variable over time and correlates well with dyspnea (75). Home monitoring of lung function by FOT in patients with COPD has recently been shown to be feasible and reliable (76), suggesting a great potential role for monitoring of FOT variability in COPD.…”

Section: Implications For Copd?mentioning

confidence: 88%

Systems Biology and Clinical Practice in Respiratory Medicine. The Twain Shall Meet

Thamrin

Frey

Kaminsky

et al. 2016

Am J Respir Crit Care Med

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Respiratory diseases are highly complex, being driven by host-environment interactions and manifested by inflammatory, structural, and functional abnormalities that vary over time. Traditional reductionist approaches have contributed vastly to our knowledge of biological systems in health and disease to date; however, they are insufficient to provide an understanding of the behavior of the system as a whole. In this Pulmonary Perspective, we discuss systems biology approaches, especially but not limited to the study of the lung as a complex system. Such integrative approaches take into account the large number of dynamic subunits and their interactions found in biological systems. Borrowing methods from physics and mathematics, it is possible to study the collective behavior of these systems over time and in a multidimensional manner. We first examine the physiological basis for complexity in the respiratory system and its implications for disease. We then expand on the potential applications of systems biology methods to study complex systems, within the context of diagnosis and monitoring of respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), and critical illness. We summarize the significant advances made in recent years using systems approaches for disease phenotyping, applied to data ranging from the molecular to clinical level, obtained from large-scale asthma and COPD networks. We describe new studies using temporal complexity patterns to characterize asthma and COPD and predict exacerbations as well as predict adverse outcomes in critical care. We highlight new methods that are emerging with this approach and discuss remaining questions that merit greater attention in the field.

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Comparison of inspiratory and expiratory resistance and reactance in patients with asthma and chronic obstructive pulmonary disease

Cited by 125 publications

References 15 publications

Clinical Application of the Forced Oscillation Technique

Clinical Application of the Forced Oscillation Technique

What Does Airway Resistance Tell Us About Lung Function?

Systems Biology and Clinical Practice in Respiratory Medicine. The Twain Shall Meet

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