The forced oscillation technique in clinical practice: methodology, recommendations and future developments

Oostveen, Ellie; MacLeod, D; Lorino, H.; Farré, Ramón; Hantos, Zoltán; Desager, Kristine; Marchal, François

doi:10.1183/09031936.03.00089403

Cited by 1,105 publications

(1,203 citation statements)

References 159 publications

(185 reference statements)

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“…In general we found that FOT outcomes were insensitive to detect underlying lung disease when examined either at one point in time, or longitudinally over 1 year. We found that the fdep and Xrs8 were the most sensitive outcomes of FOT in our cohort, which may reflect an increase in the resistance of the peripheral airways and/or an increase in ventilation inhomogeneity of the lung [36,37]. Both of these outcomes were associated with the number of neutrophils, IL-8 concentrations, presence of H. influenzae and air trapping score, although the magnitudes of the effect sizes were small and were most prominent in the cross-sectional rather than the longitudinal analysis.…”

Section: Discussionmentioning

confidence: 69%

Impact of lung disease on respiratory impedance in young children with cystic fibrosis

et al. 2015

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This study aimed to evaluate the ability of the forced oscillation technique (FOT) to detect underlying lung disease in preschool children with cystic fibrosis (CF) diagnosed following newborn screening.184 children (aged 3-6 years) with CF underwent lung function testing on 422 occasions using the FOT to assess respiratory resistance and reactance at the time of their annual bronchoalveolar lavage collection and chest computed tomography scan. We examined associations between FOT outcomes and the presence and progression of respiratory inflammation, infection and structural lung disease.Children with CF who had pronounced respiratory disease, including free neutrophil elastase activity, infection with pro-inflammatory pathogens and structural lung abnormalities had similar FOT outcomes to those children without detectable lung disease. In addition, the progression of lung disease over 1 year was not associated with worsening FOT outcomes.We conclude that the forced oscillation technique is relatively insensitive to detect underlying lung disease in preschool children with CF. However, FOT may still be of value in improving our understanding of the physiological changes associated with early CF lung disease. @ERSpublications Forced oscillation technique is insensitive in detecting lung disease in preschool children with cystic fibrosis http://ow.ly/R9rSU

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Section: Discussionmentioning

confidence: 69%

Impact of lung disease on respiratory impedance in young children with cystic fibrosis

et al. 2015

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“…Rrs values .5 SDs above the mean were discarded, as well as rare negative Rrs values probably caused by the subject's breathing occasionally generating flow components which contaminated the signal frequencies. Blocks of 1-s pressure and flow were discarded until coherence calculated over a 16-s window was .0.9 for all data analysed [15]. Furthermore, noise amplitude was estimated at a frequency from the average amplitude of the pressure and flow spectra at neighbouring nonsignal frequencies (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…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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“…Subjects were characterized during a baseline visit assessing impulse oscillometry (IOS), spirometry, body plethysmography and a conventional nebulized AMP bronchoprovocation test. [9–13] Subjects with a positive AMP response (PC 20 ≤ 320 mg ml –1 ) on this baseline visit were included.…”

Section: Methodsmentioning

confidence: 99%

“…The 40% increase in IOS parameters was based on previous studies using a threshold of 40% increase in resistance measured with the forced oscillation technique or 40% decrease in specific airway conductance measured with body plethysmography. [9,17,18] FEV 1 and R20 were considered as large airway parameters, FEF 25–75% , R5-R20 and X5 as small airway parameters.…”

Section: Methodsmentioning

confidence: 99%

Targeting the small airways with dry powder adenosine: a challenging concept

Wiel

Lexmond

Berge

et al. 2017

European Clinical Respiratory Journal

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Background: Small-particle inhaled corticosteroids (ICS) provide a higher small airway deposition than large-particle ICS. However, we are still not able to identify asthma patients who will profit most from small-particle treatment. Objective: We aimed to identify these patients by selectively challenging the small and large airways. We hypothesized that the airways could be challenged selectively using small- and large-particle adenosine, both inhaled at a high and a low flow rate. Design: In this cross-over study 11 asthma subjects performed four dry powder adenosine tests, with either small (MMAD 2.7 µm) or large (MMAD 6.0 µm) particles, inhaled once with a low flow rate (30 l min–1) and once with a high flow rate (60 l min–1). Spirometry and impulse oscillometry were performed after every bronchoprovocation step. We assumed that FEV1 reflects the large airways, and FEF25–75%, R5-R20 and X5 reflect the small airways. Results: The four adenosine tests were not significantly different with respect to the threshold values of FEV1 (p = 0.12), FEF25–75% (p = 0.37), R5-R20 (p = 0.60) or X5 (p = 0.46). Both small- and large-particle adenosine induced a response in the small airways in the majority of the tests. Conclusions: In contrast to our hypothesis, all four adenosine tests provoked a response in the small airways and we could not identify different large- or small-airway responders. Interestingly, even the test with large particles and a high flow rate induced a small-airway response, suggesting that selective challenging of the small airways is not necessary. Future studies should investigate the relation between particle deposition and the site of an airway response.

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The forced oscillation technique in clinical practice: methodology, recommendations and future developments

Cited by 1,105 publications

References 159 publications

Impact of lung disease on respiratory impedance in young children with cystic fibrosis

Impact of lung disease on respiratory impedance in young children with cystic fibrosis

Airway resistance variability and response to bronchodilator in children with asthma

Targeting the small airways with dry powder adenosine: a challenging concept

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