Comparing lung oscillometry with a novel, portable flow interrupter device to measure lung mechanics

Abstract

In the community setting, assessing spirometry in school-aged children is often limited by the unavailability of respirology technicians at the point-of-care. We developed a new technique called the Rapid Expiratory Occlusion Method (REOM) which measures respiratory resistance during normal breathing, without specialized training. The aim was to examine the concordance between respiratory resistance measured with the REOM with that measured by oscillometry on the tremoflo. Children aged 6 to 17 years, with or without asthma, received respiratory resistance testing on the tremoflo, then on the REOM. Three to five replicates with a coefficient of variation ≤15% were obtained on each instrument; the primary outcome was the concordance between the average respiratory resistance on the REOM with that measured at 5 Hz (R5) on the tremoflo. Thirty-two children (11 girls; 21 boys) were enrolled with a mean age of 11.2 (range 6-17) years; after excluding 2 children not meeting reproducibility criteria, 9 healthy controls, 15 controlled asthmatics, and 6 poorly controlled asthmatics were included. Resistance measured on the REOM showed a strong correlation with R5 measured on the tremoflo (p<0.0001) with no significant differences on the Bland-Altman analyses. Children and their parents found the REOM easy to use and would consider for home use if recommended by their doctor. With the high concordance between resistance values measured on the REOM and that on the tremoflo combined with perceived ease of use, the REOM appears as a promising means for measuring lung function, thus supporting further testing of other psychometric properties.

Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

“…Depending on the age of the pediatric patient, the forced maneuvers and coordination required for conventional spirometry are difficult for children to complete reproducibly (36). A study by Lundblad et al (37) demonstrated that respiratory resistance measured during normal (tidal) breathing using a novel handheld portable oscillometer device correlated closely with estimates obtained by conventional oscillometry in children with asthma. User experience questionnaires were favorable, including perceptions by children and their parents that the test was 'easy' and that they 'would use it at home if recommended by their health care provider' , supporting the feasibility of remote lung function monitoring even in children with asthma.…”

Oscillometry to Assess Respiratory Function in Adult Cystic Fibrosis

“…Lundblad et al proposed oscillometry as a viable alternative to spirometry to assess lung function under these circumstances since repeated FVC maneuvers (often associated with cough) would not be required. In addition, the use of Bluetooth® or similar (infrared) wireless technology would enable oscillometry to be performed under direct supervision but with sufficient distancing between subject and technician (146,148).…”