Unsupervised self-testing of airway obstruction by forced oscillation at the patient's home

Rigau, Jordi; Burgos, Felip; García-Hernández, Cristina; Roca, Josep; Navajas, Daniel; Farré, Ramón

doi:10.1183/09031936.03.00010303

Cited by 17 publications

(16 citation statements)

References 24 publications

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“…(5-15%) [19,20,26], and similar to those reported for plethysmographic measurements [9,27]. Among anthropometric variables analysed, height was the best predictor for Rrs and FN, and contribution of age and weight was either nonsignificant or negligible.…”

Section: Respiratory Resistance In the Elderly Yf Guo Et Alsupporting

confidence: 66%

Normal values for respiratory resistance using forced oscillation in subjects >65 years old

Guo

Herrmann²,

Michel³

et al. 2005

European Respiratory Journal

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The aim of the present study was to determine reference values and predictive variables for respiratory impedance (Zrs) by the forced oscillation technique (FOT) in subjects aged .65 yrs.The investigation involved a prospective study of nonsmoking subjects, with normal forced expiratory volumes. The Zrs parameters, which included average resistance between 4-16 Hz (R4-16), average resistance between 4-30 Hz (RM), resonant frequency (FN), capacitance (C) and inertance (I), were measured along with forced expiratory manoeuvres. Every subject had each parameter measured in the same sequence using FOT and spirometry.A total of 223 subjects aged 83¡8 yrs were included in the study. The mean values for forced expiratory volume in one second (FEV1) % predicted were 110¡23. The forced vital capacity (FVC) % pred was 114¡21 and the FEV1/FVC % pred was 112¡11. . In multiple regression models adjusted for age, sex, height and weight, height was the most influential predictor for Zrs parameters based on the magnitude of the regression coefficient.In conclusion, it was found that height was the best predictor for respiratory impedance parameters. Contribution of age and weight was negligible. However, the level of predictability for respiratory impedance parameters by regression equations was low.

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Section: Respiratory Resistance In the Elderly Yf Guo Et Alsupporting

confidence: 66%

Normal values for respiratory resistance using forced oscillation in subjects >65 years old

Guo

Herrmann²,

Michel³

et al. 2005

European Respiratory Journal

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“…Thus reliable measurements of impedance during quiescent breathing, especially using a portable home FOT device with telemedicine capabilities 245859 , may be useful for monitoring the dynamics of airway obstruction and its evolution over periods of weeks or months. Such data could provide far more insight into the management and control of obstructive lung diseases when compared to traditional, intermittent clinical assessment 151 .…”

Section: Discussionmentioning

confidence: 99%

“…Rigau et al have shown that FOT was potentially applicable to home monitoring 5859 . A recent study by Dellaca et al demonstrated the feasibility of using an inexpensive FOT system for real-time data acquisition, processing, and internet streaming 24 .…”

Section: Measurement Techniquesmentioning

confidence: 99%

Oscillation Mechanics of the Respiratory System: Applications to Lung Disease

Kaczka

Dellacà

2011

Crit Rev Biomed Eng

106

119

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Since its introduction in the 1950s, the forced oscillation technique (FOT) and the measurement of respiratory impedance have evolved into powerful tools for the assessment of various mechanical phenomena in the mammalian lung during health and disease. In this review, we highlight the most recent developments in instrumentation, signal processing, and modeling relevant to FOT measurements. We demonstrate how FOT provides unparalleled information on the mechanical status of the respiratory system compared to more widely-used pulmonary function tests. The concept of mechanical impedance is reviewed, as well as the various measurement techniques used to acquire such data. Emphasis is placed on the analysis of lower, physiologic frequency ranges (typically less than 10 Hz) that are most sensitive to normal physical processes as well as pathologic structural alterations. Various inverse modeling approaches used to interpret alterations in impedance are also discussed, specifically in the context of three common respiratory diseases: asthma, chronic obstructive pulmonary disease, and acute lung injury. Finally, we speculate on the potential role for FOT in the clinical arena.

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“…The Forced Oscillation Technique (FOT) measures the mechanical properties of the lung during tidal breathing in a way that is simple to perform without supervision or effort, is operator independent and can be undertaken at home by COPD patients 18,19 . FOT can also detect changes in lung mechanics acutely after a bronchodilator 20 and during recovery from an exacerbation [21][22][23] , making it a potentially attractive way to objectively define exacerbation events in a telemonitoring programme.…”

Section: Introductionmentioning

confidence: 99%

Telemonitoring in Chronic Obstructive Pulmonary Disease (CHROMED). A Randomized Clinical Trial

Walker

Pompilio²,

Zanaboni

et al. 2018

Am J Respir Crit Care Med

125

130

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Scientific Knowledge on the Subject: Despite observational studies suggesting that COPD exacerbation can be detected using a combination of symptoms and physiological measures, such as pulse and oxygen saturation, larger randomized controlled trials have not shown any effect of telemonitoring on time to first hospital admission (TTFH), hospitalization and quality of life. Tested tele-monitoring programs had a negligible impact on healthcare costs, and, in some cases, resulted in an increased healthcare utilisation. What This Study Adds to the Field:This randomized controlled trial of 312 COPD patients is the first using only objective lung function data measured daily by the forced oscillation technique to prompt early intervention. Despite being feasible and well accepted by patients, this approach did not affect TTFH and quality of life. However, it significantly reduced healthcare costs, mostly due to a reduction in duration and frequency of subsequent hospitalisations, which was greatest in patients hospitalised the year before recruitment.This article has an online data supplement, which is accessible from this issue's table of content online at www.atsjournals.org 3 AbstractRationale Early detection of COPD exacerbations using tele-monitoring of physiological variables might reduce the frequency of hospitalisation.Objectives To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique (FOT) and cardiac parameters in older COPD patients with co-morbidities.Methods This multicentre, randomized clinical trial recruited 312 GOLD grade II-IV COPD patients (median age 71 years [IQR:66-76], 49.6% grade II, 50.4% grade III-IV), with a history of exacerbation in the previous year and at least one non-pulmonary co-morbidity. Patients were randomised to usual care (n=158) or tele-monitoring (n=154) and followed for 9 months. All telemonitoring patients self-assessed lung mechanics daily and in a subgroup with congestive heart failure (n=37) cardiac parameters were monitored. An algorithm identified deterioration, triggering a telephone contact to determine appropriate interventions. Measurements and Main resultsPrimary outcomes were time to first hospitalisation (TTFH) and change in EQ-5D utility index score. Secondary outcomes included: rate of antibiotic/corticosteroid prescriptions, hospitalisation, CAT, PHQ-9 and MLHF questionnaire scores, quality-adjusted life years and healthcare costs. Tele-monitoring did not affect TTFH, EQ-5D utility index score, antibiotic prescriptions, hospitalization rate and questionnaire scores. Tele-medicine was associated with fewer repeat hospitalizations (-54%, p=0.017). Previously hospitalised patients showed the greatest reduction in hospitalization rate (-53%, p=0.017) with large potential for cost savings (-3736€/patient/year, p=0.010). ConclusionsIn older COPD patients with co-morbidities remote monitoring of lung function by FOT and cardiac parameters did not change TTFH and EQ-5D. However patients at risk of hospitalisation may benefit fr...

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Unsupervised self-testing of airway obstruction by forced oscillation at the patient's home

Cited by 17 publications

References 24 publications

Normal values for respiratory resistance using forced oscillation in subjects >65 years old

Normal values for respiratory resistance using forced oscillation in subjects >65 years old

Oscillation Mechanics of the Respiratory System: Applications to Lung Disease

Telemonitoring in Chronic Obstructive Pulmonary Disease (CHROMED). A Randomized Clinical Trial

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