Retrospective Observations on the Ability to Diagnose and Manage Patients with Asthma through the Use of Impulse Oscillometry: Comparison with Spirometry and Overview of the Literature

Abstract

Objective. Impulse oscillometry (IOS) is an evolving technology for the diagnosis and followup of patients with asthma. Our objective is to review the findings on patients who underwent both spirometry and IOS during clinical evaluations of their asthma. The goal was to retrospectively evaluate IOS during the initial diagnosis and followup of patients with asthma in comparison with spirometry. Methods. We routinely perform IOS and spirometry evaluation in patients with suspected asthma during baseline visits and at followup. We reviewed the data on 39 patients over the age of 13 with asthma at baseline and following treatment with inhaled corticosteroids. IOS and spirometry were both done at baseline, following short acting bronchodilator administration, and at followup after at least three months of inhaled corticosteroid treatment. Results. IOS showed improvement in airway function both initially, following short acting bronchodilator introduction, and later after initiation of long term inhaled corticosteroid treatment, even when the spirometry did not reveal improvement. We noted the IOS improvement in the reactance or AX as well as the resistance in smaller airways or R5. Conclusion. IOS may provide a useful measure towards identifying an asthma diagnosis and followup without inducing the extra respiratory effort spirometry requires.

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

“…We can hypothesize that the global resistance is partly related to a contribution of sputum to luminal airway occlusion. Several studies have also emphasized the potential for FOT to enable better understanding of the complex pathophysiology of obstructive lung diseases such as asthma [ 31 ] and COPD [ 10 ].…”

Priorities for future research into asthma diagnostic tools: A PAN‐EU consensus exercise from the European asthma research innovation partnership (EARIP)

“…97 More recent studies demonstrated the efficacy of IOS as an alternative to FEV1 in older asthmatic children. 98,99 Interestingly, it has been shown that R5 but not FEV1 showed improvement in patients with persistent asthma after inhaled steroid treatment. 100 Forced oscillation technique holds the perspective of improving Normal values of respiratory impedance (Zrs) for preschool children have been obtained, as well as of respiratory resistance (Rrs).…”

Clinical Applications of Impulse Oscillometry

“…Response to treatment can be gauged via handheld nebulizer treatment in the acute setting. In addition, treatment with inhaled corticosteroids or inhaled corticosteroid/LABA or long-acting beta agonists has also been observed independent of spirometry [2]. We will also review the literature regarding the comparison of this modality to traditional spirometry.…”