Intra-breath oscillometry for assessing respiratory outcomes

Hantos, Zoltán

doi:10.1016/j.cophys.2021.05.004

Cited by 21 publications

(26 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is the first study to apply both conventional (spectral) and intrabreath oscillometry for characterisation of patients with IPF who meet the consensus guidelines definition, and to evaluate the correlations of oscillometry with CT-derived metrics of lung volume and lung injury. Intrabreath oscillometry is a novel modality that evaluates dynamic changes in the airways and respiratory tissues during the breathing cycle using a tracking signal with sufficient temporal resolution (0.1 s in the current study) 17 25. We observed excellent correlations of XeI with ILD extent and PVV, which remained significant after adjusting for %FVC, %DLCO and GAP score.…”

Section: Discussionmentioning

confidence: 58%

Correlation of respiratory oscillometry with CT image analysis in a prospective cohort of idiopathic pulmonary fibrosis

Nguyen

et al. 2022

BMJ Open Resp Res

Self Cite

View full text Add to dashboard Cite

BackgroundMarkers of idiopathic pulmonary fibrosis (IPF) severity are based on measurements of forced vital capacity (FVC), diffusing capacity (DLCO) and CT. The pulmonary vessel volume (PVV) is a novel quantitative and independent prognostic structural indicator derived from automated CT analysis. The current prospective cross-sectional study investigated whether respiratory oscillometry provides complementary data to pulmonary function tests (PFTs) and is correlated with PVV.MethodsFrom September 2019 to March 2020, we enrolled 89 patients with IPF diagnosed according to international guidelines. We performed standard spectral (5–37 Hz) and novel intrabreath tracking (10 Hz) oscillometry followed by PFTs. Patients were characterised with the gender-age-physiology (GAP) score. CT images within 6 months of oscillometry were analysed in a subgroup (26 patients) using automated lung texture analysis. Correlations between PFTs, oscillometry and imaging variables were investigated using different regression models.FindingsThe cohort (29F/60M; age=71.7±7.8 years) had mild IPF (%FVC=70±17, %DLCO=62±17). Spectral oscillometry revealed normal respiratory resistance, low reactance, especially during inspiration at 5 Hz (X5in), elevated reactance area and resonance frequency. Intrabreath oscillometry identified markedly low reactance at end-inspiration (XeI). XeI and X5in strongly correlated with FVC (r2=0.499 and 0.435) while XeI was highly (p=0.004) and uniquely correlated with the GAP score. XeI and PVV exhibited the strongest structural-functional relationship (r2=0.690), which remained significant after adjusting for %FVC, %DLCO and GAP score.InterpretationXeI is an independent marker of IPF severity that offers additional information to standard PFTs. The data provide a cogent rationale for adding oscillometry in IPF assessment.

show abstract

Section: Discussionmentioning

confidence: 58%

Correlation of respiratory oscillometry with CT image analysis in a prospective cohort of idiopathic pulmonary fibrosis

Nguyen

et al. 2022

BMJ Open Resp Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, new lung mechanics techniques evolving from experimental physiology can be used in spontaneously ventilated patients. Notably, forced oscillation technique, or oscillometry, has contributed to a better understanding of lung function in clinical routine and in research, particularly in patients with obstructive disease ( Peterson-Carmichael et al, 2016 ; Hantos, 2021 ; Lundblad and Robichaud, 2021 ).…”

Section: Lung Physiology In Human Subjects: Mechanical Ventilation An...mentioning

confidence: 99%

“…According to Hantos ( Hantos, 2021 ), manoeuvres using oscillometry involving large but slow changes in lung volume allows for fine mapping of respiratory mechanics exceeding the tidal range and a novel intra-breath modality is capable of tracking the dynamic changes in respiratory system.…”

Section: Lung Physiology Still Not At Bedside Primetimementioning

confidence: 99%

Lung Mechanics Over the Century: From Bench to Bedside and Back to Bench

et al. 2022

View full text Add to dashboard Cite

Lung physiology research advanced significantly over the last 100 years. Respiratory mechanics applied to animal models of lung disease extended the knowledge of the workings of respiratory system. In human research, a better understanding of respiratory mechanics has contributed to development of mechanical ventilators. In this review, we explore the use of respiratory mechanics in basic science to investigate asthma and chronic obstructive pulmonary disease (COPD). We also discuss the use of lung mechanics in clinical care and its role on the development of modern mechanical ventilators. Additionally, we analyse some bench-developed technologies that are not in widespread use in the present but can become part of the clinical arsenal in the future. Finally, we explore some of the difficult questions that intensive care doctors still face when managing respiratory failure. Bringing back these questions to bench can help to solve them. Interaction between basic and translational science and human subject investigation can be very rewarding, as in the conceptualization of “Lung Protective Ventilation” principles. We expect this interaction to expand further generating new treatments and managing strategies for patients with respiratory disease.

show abstract

“…Recent work has demonstrated its feasibility in normally breathing unsedated infants with a high success rate ( 2 – 5 ). Additionally, a new tracking modality of oscillometry ( 6 ) has revealed disease-specific patterns of intra-breath changes in Zrs and has proven unique in predicting lower respiratory tract illness during infancy ( 7 ). However, a comprehensive analysis is still needed to fully characterize the intra-breath dynamics of Zrs in infants, with special regard to the substantial contribution of the upper airways ( 8 – 12 ).…”

Section: Introductionmentioning

confidence: 99%

Respiratory Oscillometry in Newborn Infants: Conventional and Intra-Breath Approaches

et al. 2022

Self Cite

View full text Add to dashboard Cite

BackgroundOscillometry has been employed widely as a non-invasive and standardized measurement of respiratory function in children and adults; however, limited information is available on infants.AimsTo establish the within-session variability of respiratory impedance (Zrs), to characterize the degree and profile of intra-breath changes in Zrs and to assess their impact on conventional oscillometry in newborns.Methods109 healthy newborns were enrolled in the study conducted in the first 5 postpartum days during natural sleep. A custom-made wave-tube oscillometry setup was used, with an 8–48 Hz pseudorandom and a 16 Hz sinusoidal signal used for spectral and intra-breath oscillometry, respectively. A resistance-compliance-inertance (R-C-L) model was fitted to average Zrs spectra obtained from successive 30-s recordings. Intra-breath measures, such as resistance (Rrs) and reactance (Xrs) at the end-expiratory, end-inspiratory and maximum-flow points were estimated from three 90-s recordings. All natural and artifact-free breaths were included in the analysis.ResultsWithin-session changes in the mean R, C and L values, respectively, were large (mean coefficients of variation: 10.3, 20.3, and 26.6%); the fluctuations of the intra-breath measures were of similar degree (20–24%). Intra-breath analysis also revealed large swings in Rrs and Xrs within the breathing cycle: the peak-to-peak changes amounted to 93% (range: 32–218%) and 41% (9–212%), respectively, of the zero-flow Zrs magnitude.DiscussionIntra-breath tracking of Zrs provides new insight into the determinants of the dynamics of respiratory system, and highlights the biasing effects of mechanical non-linearities on the average Zrs data obtained from the conventional spectral oscillometry.

show abstract

Intra-breath oscillometry for assessing respiratory outcomes

Cited by 21 publications

References 50 publications

Correlation of respiratory oscillometry with CT image analysis in a prospective cohort of idiopathic pulmonary fibrosis

Correlation of respiratory oscillometry with CT image analysis in a prospective cohort of idiopathic pulmonary fibrosis

Lung Mechanics Over the Century: From Bench to Bedside and Back to Bench

Respiratory Oscillometry in Newborn Infants: Conventional and Intra-Breath Approaches

Contact Info

Product

Resources

About