Advantage of impulse oscillometry over spirometry to diagnose chronic obstructive pulmonary disease and monitor pulmonary responses to bronchodilators: An observational study

Abstract

Objectives:This retrospective study was a comparative analysis of sensitivity of impulse oscillometry and spirometry techniques for use in a mixed chronic obstructive pulmonary disease group for assessing disease severity and inhalation therapy.Methods:A total of 30 patients with mild-to-moderate chronic obstructive pulmonary disease were monitored by impulse oscillometry, followed by spirometry. Lung function was measured at baseline after bronchodilation and at follow-up (3–18 months). The impulse oscillometry parameters were resistance in the small and large airways at 5 Hz (R5), resistance in the large airways at 15 Hz (R15), and lung reactance (area under the curve X; AX).Results:After the bronchodilator therapy, forced expiratory volume in 1 second (FEV1) readings evaluated by spirometry were unaffected at baseline and at follow-up, while impulse oscillometry detected an immediate improvement in lung function, in terms of AX (p = 0.043). All impulse oscillometry parameters significantly improved at follow-up, with a decrease in AX by 37% (p = 0.0008), R5 by 20% (p = 0.0011), and R15 by 12% (p = 0.0097).Discussion:Impulse oscillometry parameters demonstrated greater sensitivity compared with spirometry for monitoring reversibility of airway obstruction and the effect of maintenance therapy. Impulse oscillometry may facilitate early treatment dose optimization and personalized medicine for chronic obstructive pulmonary disease patients.

Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control

“…In this sample of predominantly well‐controlled asthmatic patients, the resistance measures from FOT gave at least as much information as the FEV 1 /FVC ratio with regard to a likelihood of asthma. These results are in line with previous studies on bronchodilator change in FOT resistance measures and spirometry in children and adults and support a potential use of FOT in asthma diagnosis and management, especially in patients not capable of acceptable spirometry manoeuvres. Altered FOT variables, reflecting small airways, were reported recently by Hafez et al .…”

Prevalence of Small-Airway Dysfunction among COPD Patients with Different GOLD Stages and Its Role in the Impact of Disease

“…However, while in patients with asthma the role of SAD as a therapeutic target for extra-fine formulations is consolidated by an increasing peripheral airways drug deposition [26], in COPD this role is not yet fully established, although improvements in air trapping and dyspnoea perception [27] and in other patient-related outcomes [28] have been demonstrated. Finally, the possibility to have a methodology such as IOS that is able to provide evaluation of the treatment effect in COPD patients [15,29,30] may open functional and clinical scenarios in the opportunity to target pharmacotherapy and make progress towards to personalized management [3]. …”

Forty years of reference values for respiratory system impedance in adults: 1977–2017

“…Current literature provides sufficient evidence for a role of impedance measurements as complimentary to history, physical examination, spirometry, and imaging in the evaluation of patients with large and small airways disease as well as parenchymal lung diseases. [26,27]. Aside from its relevance in elderly and debilitated patient populations due to the above mentioned technical advantages, patterns of respiratory impedance have been described in patients with obstructive lung disease [28], diffuse interstitial lung disease [29], bronchiolitis obliterans syndrome in lung transplant recipients [30], upper airway obstruction [31], vocal cord dysfunction [32], musculoskeletal thoracic abnormalities [33], and obstructive sleep apnea [34], amongst others.…”