Forced Oscillation Technique vs Spirometry to Assess Bronchodilatation in Patients With Asthma and COPD

Zérah, Françoise; Lorino, A. M.; Lorino, H.; Harf, Alain; Macquin‐Mavier, I.

doi:10.1378/chest.108.1.41

Cited by 77 publications

(71 citation statements)

References 26 publications

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“…By contrast, in obstructive patients, Rω exhibits a negative frequency-dependence, which mostly occurs below 16 Hz, and is better described by two regression lines [8]. However, although the two-segment model allows description of the frequency dependence of Rω [8], it is not completely satisfactory, because it does not afford any physiological interpretation of this frequency dependence.…”

Section: Discussionmentioning

confidence: 97%

“…By contrast, in patients with airway obstruction or in subjects shown to be hyperreactive on bronchial challenge, resistive impedance displays a marked negative frequency dependence up to about 16 Hz, and at least two straight line segments are then necessary to approximate it by linear functions of frequency. Consequently, the estimation of R0 by linear regression analysis of resistive impedance vs frequency can only be made on a reduced frequency range, such as 4-16 Hz [8]. Whereas the parameters of such multisegment models are easy to calculate, their physiological interpretation may seem questionable.…”

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confidence: 99%

See 1 more Smart Citation

Respiratory resistive impedance in obstructive patients: linear regression analysis vs viscoelastic modelling

Lorino

Zérah²,

Mariette³

et al. 1997

Eur Respir J

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The aim of this study was to test the ability of a simple two segment model to describe the frequency dependence of resistive impedance in obstructive patients, and to investigate the significance of parameters derived from this model.The study was performed in 38 patients, in the basal state and after inhalation of 200 µg salbutamol. Impedance data measured over 4-32 Hz were fitted by a general four parameter viscoelastic model describing gas redistribution, and completed by an inertial component. This model yielded Newtonian resistance (Rmin) and maximal resistance (Rmax = Rmin plus delayed resistance due to gas redistribution). Resistive impedance data were also submitted to linear regression analysis over the 4-16 and 17-32 Hz frequency ranges, which, respectively, yielded resistive impedance extrapolated at 0 Hz (R0) and resistive impedance estimated at 32 Hz (R32). R0 and R32 were compared to Rmax and Rmin, respectively. The airway response to salbutamol inhalation was assessed by the percentage changes in these parameters (R0%, R32%, Rmax%, and Rmin%, respectively).Significant linear correlations (p<0.0001) were found between R0 and Rmax, R32 and Rmin, and R0% and Rmax%. Furthermore, the linear regression lines of R0 vs Rmax, and R0% vs Rmax%, were not significantly different from the identity line.These results demonstrate that resistive impedance extrapolated at zero frequency is equivalent to maximal resistive impedance, and can be proposed as an index, not only of the level of airway obstruction, but also of its reversibility. Eur Respir J., 1997; 10: 150-155 The standard forced oscillation technique (FOT) is a convenient method for measuring respiratory resistance without the need for patient co-operation. In normal subjects, the resistive respiratory impedance derived from this technique, appears to be a linear function of frequency over the usual range (4-32 Hz). Resistive impedance can, therefore, be characterized by two parameters, namely its intercept with the ordinate axis, which represents respiratory resistance extrapolated at zero frequency (R0), and its slope (S) which is then close to zero [1][2][3][4][5][6][7]. By contrast, in patients with airway obstruction or in subjects shown to be hyperreactive on bronchial challenge, resistive impedance displays a marked negative frequency dependence up to about 16 Hz, and at least two straight line segments are then necessary to approximate it by linear functions of frequency. Consequently, the estimation of R0 by linear regression analysis of resistive impedance vs frequency can only be made on a reduced frequency range, such as 4-16 Hz [8]. Whereas the parameters of such multisegment models are easy to calculate, their physiological interpretation may seem questionable.The frequency dependence of respiratory resistive impedance over 4-32 Hz is usually interpreted in terms of series or parallel gas redistribution and described by the corresponding Mead or Otis models [9,10]. Whereas the parameters derived from these two compartment visco...

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Respiratory resistive impedance in obstructive patients: linear regression analysis vs viscoelastic modelling

Lorino

Zérah²,

Mariette³

et al. 1997

Eur Respir J

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“…Thus, neither the BD response in FEV1 nor Rrs distinguished between children with and without mild-to-moderate asthma. While Rrs and FEV1 have been used to assess function BD and have been used to distinguish disease [28,31], there is no consensus on either the sensitivity or the correlation between methods in BD testing [15].…”

Section: Spirometry and Rrsmentioning

confidence: 99%

Airway resistance variability and response to bronchodilator in children with asthma

Lall¹,

Cheng²,

Hernández³

et al. 2007

Eur Respir J

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Variability of airway function is a feature of asthma, spanning timescales from months to seconds. Short-term variation in airway resistance (Rrs) is elevated in asthma and is thought to be due to increased variation in the contractile activation of airway smooth muscle. If true, then variation in Rrs should decrease in response to bronchodilators, but this has not been investigated.Using the forced oscillation technique, Rrs and the variation in Rrs from 4-34 Hz were measured in 39 children with well-controlled mild-to-moderate asthma and 31 healthy controls (7-13 yrs) before and after an inhaled bronchodilator (200 mg salbutamol) or placebo.In agreement with other findings, baseline Rrs at all frequencies and the SD of Rrs (Rrs SD) below 14 Hz were found to be elevated in asthma while neither forced expiratory volume in one second nor the mean forced expiratory flow between 25 and 75% of forced vital capacity were different compared with controls. The present authors found that Rrs SD changed the most of any measurement in asthma, and this was the only measurement that changed significantly more in children with asthma following bronchodilator administration.The present results show that like airway narrowing, short-term airway variability of resistance may be a characteristic feature of asthma that may be useful for monitoring response to therapy.

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“…Therefore, IOS is advantageous in that results cannot be manipulated by the patient [86], nor does it induce respiratory fatigue [87]. In addition, IOS has previously been identified to correlate with both FEV1 [88,89] and airway resistance [90,91] as determined by spirometry and body plethysmography respectively. Specific to EIB, IOS has been shown to be an acceptable measure to supplement spirometry following EVH [92].…”

Section: Impulse Oscillometrymentioning

confidence: 99%

Advances in the diagnosis of exercise-induced bronchoconstriction

Price

Hull

Ansley

2014

Expert Review of Respiratory Medicine

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Forced Oscillation Technique vs Spirometry to Assess Bronchodilatation in Patients With Asthma and COPD

Cited by 77 publications

References 26 publications

Respiratory resistive impedance in obstructive patients: linear regression analysis vs viscoelastic modelling

Respiratory resistive impedance in obstructive patients: linear regression analysis vs viscoelastic modelling

Airway resistance variability and response to bronchodilator in children with asthma

Advances in the diagnosis of exercise-induced bronchoconstriction

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