The Influence of Different Mouthpieces on Impulse Oscillometry Results

Dionísio, Gustavo Henrique; Santos, Daniele; Perossi, Larissa; Paula, Mayara Holtz de; Souza, Hugo Celso Dutra de; Gastaldi, Ada Clarice

doi:10.4187/respcare.05471

Cited by 12 publications

(9 citation statements)

References 30 publications

(36 reference statements)

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“…5,17 Values of resonance frequency can be higher in the case of lung disorders, both restrictive and obstructive. 18,19 The area of reactance (AX) includes the area under the reactance curve from lowest frequency to Fres; increased values were correlated with distal obstruction.…”

Section: Parametersmentioning

confidence: 99%

<p>Lung Function Assessment by Impulse Oscillometry in Adults</p>

Porojan-Suppini¹,

Fira-Mlădinescu²,

Marc³

et al. 2020

TCRM

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Over the past decades, impulse oscillometry (IOS) has gained ground in the battery of pulmonary function tests. Performing the test requires minimal cooperation of the patient; therefore, it is a useful tool, especially in evaluating lung mechanics in children, elderly patients, and those who cannot perform spirometry. Oscillometry has also been used in both clinical and research departments. Studies were published mainly in asthma regarding detection of bronchodilator response and the therapeutic response to different drugs. Furthermore, it has been shown to be a sensitive technique to evaluate disease control. Other studied diseases were COPD, interstitial lung diseases, small airway disease, impairment of lung function due to exposure to occupational hazards or smoking, central airways obstruction, cystic fibrosis, monitoring lung mechanics during mechanical ventilation and sleep, neuromuscular diseases, lung transplant, and graft function. The aim of this review is to present the utility of oscillometry on the previously mentioned clinical fields.

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Section: Parametersmentioning

confidence: 99%

<p>Lung Function Assessment by Impulse Oscillometry in Adults</p>

Porojan-Suppini¹,

Fira-Mlădinescu²,

Marc³

et al. 2020

TCRM

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“…Concerns have been raised about the low-impedance calibration devices used in some equipment despite methodological recommendations published long ago [5,6], which are far too small compared to the Z rs values encountered in clinical practice. Another concern relates to the simplistic correction for the filter-mouthpiece assembly, which does not take into account the shunt effect of the associated dead spaces on the measured Z rs [15,30].…”

Section: Discussionmentioning

confidence: 99%

Comparison of oscillometry devices using active mechanical test loads

et al. 2019

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Noninvasiveness, low cooperation demand and the potential for detailed physiological characterisation have promoted the use of oscillometry in the assessment of lung function. However, concerns have been raised about the comparability of measurement outcomes delivered by the different oscillometry devices. The present study compares the performances of oscillometers in the measurement of mechanical test loads with and without simulated breathing.Six devices (five were commercially available and one was custom made) were tested with mechanical test loads combining resistors (R), gas compliances (C) and a tube inertance (L), to mimic respiratory resistance (R rs ) and reactance (X rs ) spectra encountered in clinical practice. A ventilator was used to simulate breathing at tidal volumes of 300 and 700 mL at frequencies of 30 and 15 min −1 , respectively. Measurements were evaluated in terms of R, C, L, resonance frequency ( f res ), reactance area (A X ) and resistance change between 5 and 20 or 19 Hz (R 5-20(19) ).Increasing test loads caused progressive deviations in R rs and X rs from calculated values at various degrees in the different oscillometers. While mean values of R rs were recovered acceptably, some devices exhibited serious distortions in the frequency dependences of R rs and X rs , leading to large errors in C, L, f res , A X and R 5-20(19) . The results were largely independent of the simulated breathing.Simplistic calibration procedures and mouthpiece corrections, in addition to unknown instrumental and signal processing factors, may be responsible for the large differences in oscillometry measures. Rigorous testing and ongoing harmonisation efforts are necessary to better exploit the diagnostic and scientific potential of oscillometry. @ERSpublicationsThe clinical utility of oscillometry is limited by the lack of standardisation of devices. This study tested six oscillometers, and reveals very different performances at higher mechanical impedances observed in children and adults with lung disease. http://bit.ly/317sfjHCite this article as: Dandurand RJ, Lavoie J-P, Lands LC, et al. Comparison of oscillometry devices using active mechanical test loads.

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“…There are numerous bacterial filters available for use with oscillometric systems, which will have a range of resistances. A single study showed differences in impedance measured with different filters by IOS in healthy adults [91]. A single study using the interrupter method in asthmatic children aged 4-16 years found a mean increase of 1.2 hPa•s•L −1 , but there was a wide variance of ±3.4 hPa•s•L −1 [92].…”

Section: System Resistance and Dead Spacementioning

confidence: 99%

Technical standards for respiratory oscillometry

King

Bates

Berger³

et al. 2019

Eur Respir J

385

496

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Oscillometry (also known as the forced oscillation technique) measures the mechanical properties of the respiratory system (upper and intrathoracic airways, lung tissue and chest wall) during quiet tidal breathing, by the application of an oscillating pressure signal (input or forcing signal), most commonly at the mouth. With increased clinical and research use, it is critical that all technical details of the hardware design, signal processing and analyses, and testing protocols are transparent and clearly reported to allow standardisation, comparison and replication of clinical and research studies. Because of this need, an update of the 2003 European Respiratory Society (ERS) technical standards document was produced by an ERS task force of experts who are active in clinical oscillometry research.The aim of the task force was to provide technical recommendations regarding oscillometry measurement including hardware, software, testing protocols and quality control.The main changes in this update, compared with the 2003 ERS task force document are 1) new quality control procedures which reflect use of “within-breath” analysis, and methods of handling artefacts; 2) recommendation to disclose signal processing, quality control, artefact handling and breathing protocols (e.g. number and duration of acquisitions) in reports and publications to allow comparability and replication between devices and laboratories; 3) a summary review of new data to support threshold values for bronchodilator and bronchial challenge tests; and 4) updated list of predicted impedance values in adults and children.

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The Influence of Different Mouthpieces on Impulse Oscillometry Results

Abstract: A circular mouthpiece coupled with a free-flow piece (B3) appeared to be the most suitable mouthpiece for the impulse oscillometry tests. It assured smaller impedance values for the respiratory system, and subjects expressed the most confidence in using this mouthpiece.

Cited by 12 publications

References 30 publications

<p>Lung Function Assessment by Impulse Oscillometry in Adults</p>

<p>Lung Function Assessment by Impulse Oscillometry in Adults</p>

Comparison of oscillometry devices using active mechanical test loads

Technical standards for respiratory oscillometry

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