The Forced Oscillation Technique in Paediatric Respiratory Practice

Skylogianni, Eleni; Douros, Konstantinos; Anthracopoulos, Michael B.; Fouzas, Sotirios

doi:10.1016/j.prrv.2015.11.001

Cited by 30 publications

(45 citation statements)

References 69 publications

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“…The method is noninvasive and requires minimal patient cooperation, which makes it suitable for use in young pediatric patients. In the context of asthma, FOT may be more sensitive than spirometry in identifying disturbances of peripheral airways and assessing the level of asthma control or the effectiveness of therapy at the long term ( 47 ). Further research is required to determine the exact role of FOT as an objective monitoring tool in pediatric asthma.…”

Section: Assessment Of Asthma Controlmentioning

confidence: 99%

Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population

et al. 2018

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Evaluating the degree of disease control is pivotal when assessing a patient with asthma. Asthma control is defined as the degree to which manifestations of the disease are reduced or removed by therapy. Two domains of asthma control are identified in the guidelines: symptom control and future risk of poor asthma outcomes, including asthma attacks, accelerated decline in lung function, or treatment-related side effects. Over the past decade, the definition and the tools of asthma control have been substantially implemented so that the majority of children with asthma have their disease well controlled with standard therapies. However, a small subset of asthmatic children still requires maximal therapy to achieve or maintain symptom control and experience considerable morbidity. Childhood uncontrolled asthma is a heterogeneous group and represents a clinical and therapeutic challenge requiring a multidisciplinary systematic assessment. The identification of the factors that may contribute to the gain or loss of control in asthma is essential in differentiating children with difficult-to-treat asthma from those with severe asthma that is resistant to traditional therapies. The aim of this review is to focus on current concept of asthma control, describing monitoring tools currently used to assess asthma control in clinical practice and research, and evaluating comorbidities and modifiable and non-modifiable factors associated with uncontrolled asthma in children, with particular reference to severe asthma.

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Section: Assessment Of Asthma Controlmentioning

confidence: 99%

Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population

et al. 2018

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“…Large negative variations of respiratory system reactance during expiration are highly sensitive and specific index of EFL presence during experimental and clinical ventilation [25,36]. The method is highly sensitive and specific, and its applications become more and more popular in clinical practice, especially during spontaneous breathing [29][30][31][32][33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Non-interventional monitoring of expiratory flow limitation during experimental mechanical ventilation

et al. 2020

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BackgroundΕxpiratory flow limitation (EFL) is common among ICU patients under mechanical ventilation (MV) and may have significant clinical consequences. In the present study, we examine the possibility of non-interventional detection of EFL during experimental MV.MethodsEight artificially ventilated New Zealand rabbits were included in the experiments. EFL was induced during MV by application of negative expiratory pressure (−5, −8 and −10 hPa) and detected by the negative expiratory pressure (NEP) technique. Airway pressure (Paw) and flow (Vʹ) were digitally recorded and processed off-line for the evaluation of respiratory mechanics. The method is based on the computation and monitoring of instantaneous respiratory resistance Rrs(t). The resistive pressure (Paw,res(t)) is calculated by subtracting from Paw its elastic component and the end expiratory pressure (EEP), as assessed by linear regression. Then, Rrs(t) is computed as the instant ratio Paw,res(t)/Vʹ(t).ResultsTwo completely different patterns of expiratory Rrs(t) separate the cases with EFL from those without EFL. Small and random fluctuations are noticed when EFL is absent, whereas the onset of EFL is accompanied by an abrupt and continuous rise in Rrs(t), towards the end of expiration. Thus, EFL is not only detected but may also be quantified from the volume still to be expired at the time EFL occurs.ConclusionThe proposed technique is a simple, accurate and non-interventional tool for the EFL monitoring during MV.

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“…We established a protocol for cotton rats which allowed us to use forced oscillation technique, via the flexiVent system, to accurately define the effects of asthma and RSV on lung mechanics (e.g. resistance and compliance) [28,33,34]. In addition, we measured arterial blood gases during infection to accurately quantify the clinical perturbations of lung function [35].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary function analysis in cotton rats after respiratory syncytial virus infection

et al. 2020

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The cotton rat (Sigmodon hispidus) is an excellent small animal model for human respiratory viral infections such as human respiratory syncytial virus (RSV) and human metapneumovirus (HMPV). These respiratory viral infections, as well as other pulmonary inflammatory diseases such as asthma, are associated with lung mechanic disturbances. So far, the pathophysiological effects of viral infection and allergy on cotton rat lungs have not been measured, although this information might be an important tool to determine the efficacy of vaccine and drug candidates. To characterize pulmonary function in the cotton rat, we established forced oscillation technique in uninfected, RSV infected and HDM sensitized cotton rats, and characterized pulmonary inflammation, mucus production, pulmonary edema, and oxygenation. There was a gender difference after RSV infection, with females demonstrating airway hyper-responsiveness while males did not. Female cotton rats 2dpi had a mild increase in pulmonary edema (wet: dry weight ratios). At day 4 post infection, female cotton rats demonstrated mild pulmonary inflammation, no increase in mucus production or reduction in oxygenation. Pulmonary function was not significantly impaired after RSV infection. In contrast, cotton rats sensitized to HDM demonstrated airway hyperresponsiveness with a significant increase in pulmonary inflammation, increase in baseline tissue damping, and a decrease in baseline pulmonary compliance. In summary, we established baseline data for forced oscillation technique and other respiratory measures in the cotton rat and used it to analyze respiratory diseases in cotton rats.

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The Forced Oscillation Technique in Paediatric Respiratory Practice

Cited by 30 publications

References 69 publications

Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population

Difficult vs. Severe Asthma: Definition and Limits of Asthma Control in the Pediatric Population

Non-interventional monitoring of expiratory flow limitation during experimental mechanical ventilation

Pulmonary function analysis in cotton rats after respiratory syncytial virus infection

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