Respiratory mechanics measured by forced oscillation technique in combined pulmonary fibrosis and emphysema

Mori, Kazutaka; Shirai, Toshihiro; Mikamo, Masashi; Shishido, Yoshihiro; Akita, Takefumi; Morita, Satoru; Asada, Kazuhiro; Fujisawa, Masato; Hozumi, Hironao; Suda, Takafumi; Chida, Kingo

doi:10.1016/j.resp.2012.10.009

Cited by 51 publications

(44 citation statements)

References 15 publications

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“…The discrepancy in the results of the studies may be attributed to different samples and FOT apparatuses. We confirmed that there was no difference in Fres between patients with ILD and those with mild to moderate COPD (53). However, Fres did not correlate with the emphysema score in patients with COPD.…”

Section: Interstitial Lung Disease (Ild)supporting

confidence: 71%

“…R20 was significantly lower in patients with CPFE than in those with interstitial pneumonia (IP) or COPD, irrespective of the severity of airflow limitation (53). ΔX5 in patients with CPFE was significantly higher than in those with IP and lower than in those with COPD, suggesting that both emphysema and fibrosis affect the lung mechanics in CPFE, leading to different findings from IP or COPD alone.…”

Section: Combined Pulmonary Fibrosis and Emphysema (Cpfe)mentioning

confidence: 96%

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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: Interstitial Lung Disease (Ild)supporting

confidence: 71%

Section: Combined Pulmonary Fibrosis and Emphysema (Cpfe)mentioning

confidence: 96%

Clinical Application of the Forced Oscillation Technique

Shirai

Kurosawa

2016

Intern. Med.

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“…Using the FOT, the mechanical properties of the lung have been characterized in humans (Dubois et al 1956;Kaczka et al 1997). As commercially available instruments were developed, the FOT has been used to assess respiratory functions of patients with respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung disease (Yaegashi et al 2007;Kanda et al 2010;Paredi et al 2010;Crim et al 2011;Mori et al 2011;Ohishi et al 2011;Ito et al 2012;Mori et al 2013). …”

Section: Introductionmentioning

confidence: 99%

Influence of cheek support on respiratory impedance measured by forced oscillation technique

et al. 2013

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The forced oscillation technique (FOT) is a useful tool to assess respiratory resistance and reactance during tidal breathing in patients with respiratory diseases, specifically asthma and chronic obstructive pulmonary disease. Although the FOT has been clinically used, results of respiratory impedance can be affected by various factors such as upper airway artifact. We investigated the effects of cheek support on respiratory resistance and reactance measured by a commercially available FOT equipment MostGraph-01. Respiratory resistance at 20 Hz (R20) with support of the cheeks was significantly higher than those without the cheek support in healthy subjects. Two different cheek support protocols, support of the cheeks by subjects themselves and an operator, were compared in healthy volunteers and patients with respiratory diseases. The cheek support protocols significantly affected respiratory resistance at 5 Hz (R5) and reactance at 5 Hz (X5) in the patient group but not in the healthy subjects. Moreover, for X5, there was a significant interaction between cheek support protocols (by a subject or operator) and groups (healthy or diseased). In conclusion, during impedance measurements using the FOT, application of cheek support either by subjects or the operator is recommended to reduce upper airway artifacts, however, results obtained by two protocols may be different in patients with respiratory diseases. Contribution of the chest wall and position of the arms to the mechanical properties should be carefully considered in physiological studies in which the FOT is attempted.

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“…TLC correlates positively with the emphysema score at HRCT, and inversely correlates with the fi brosis score; conversely, FEV 1 :FVC negatively correlates with the emphysema score at HRCT, and positively correlates with FEV 1 :FVC [ 99 ]. Analysis of respiratory impedance by multi-frequency forced oscillation technique found lower whole-breath, inspiratory or expiratory resistance in CPFE patients than in chronic obstructive pulmonary disease, and lower whole-breath and expiratory resistance in CPFE than in ILD without emphysema, further supporting the hypothesis of pseudonormalisation of lung mechanics in CPFE [ 100 ]. Conversely, both disease components concur to reduced alveolar capillar gas exchange through either decreased capillary blood volume or alveolar membrane thickening.…”

Section: Clinical Vignettementioning

confidence: 59%

“…Other studies have defi ned CPFE as IPF (according to international criteria for the diagnosis of IPF at the time) with associated emphysema at imaging, using various thresholds or defi nitions for emphysema, including emphysema being notable or at least equivalent in extent to the fi brosis ("moderate emphysema") [ 17 ]; or IPF with emphysema score ≥4/24 and fi brosis score ≥4/24, with scores based on estimates of the percentage of low attenuation areas (or of areas with reticulation/honeycombing) at three anatomic levels in both lungs (with emphysema and fi brosis considered signifi cant when present in over half of the total lung fi elds) [ 100 ]; or IPF with >10 % of the lung affected with emphysematous changes [ 16 ]; or IPF with total emphysema score ≥10 % [ 18 ], a thresholds that corresponds to GOLD stage II or worse in patients with isolated chronic obstructive pulmonary disease; etc.…”

Section: Diagnosis Of the Cpfe Syndromementioning

confidence: 99%