Usefulness of impulse oscillometry for the assessment of airway hyperresponsiveness in mild-to-moderate adult asthma

Short, Philip; Anderson, William J.; Manoharan, Arvind; Lipworth, Brian J.

doi:10.1016/j.anai.2015.04.022

Cited by 27 publications

(23 citation statements)

References 15 publications

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“…When comparing our results for methacholine challenge changes in IOS indexes to others in the literature, we see that ours are similar to those reported by Short et al Nevertheless, other authors showed greater variations in oscillometric indexes. In the group of patients with a positive challenge with mannitol, the median variation of FEV1 and R5 was 17.95% and 18.75%, respectively.…”

Section: Discussionsupporting

confidence: 92%

Comparison of impulse oscillometry and spirometry for detection of airway hyperresponsiveness to methacholine, mannitol, and eucapnic voluntary hyperventilation in children

Jara-Gutierrez

Aguado

Potro

et al. 2019

Pediatric Pulmonology

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Background Forced expiratory maneuvers are usually difficult in young children. Impulse oscillometry (IOS) requires no active cooperation, is noninvasive, rapid, and easy to perform. This study aimed to compare IOS indexes and forced expiratory volume in 1 second (FEV1) in children for the assessment of bronchial hyperreactivity to methacholine, mannitol, and eucapnic voluntary hyperventilation (EVH). Materials Children aged 3‐14 years (mean 10.0 ± 3.1) with symptoms suggestive of asthma were recruited. IOS measurements were taken before spirometry. Methacholine, mannitol, and EVH tests were performed without a specific order. Results We included 190 children, whose mean age was 10.0 ± 3.1 years. Changes in FEV1 correlated significantly with variation in IOS indexes (P < .05). The indexes with the greatest discriminative capacity were Z5, R5, and X5. Optimal cut‐offs were: for methacholine tests, ≧22% in R5, ≧82% for reactance area (AX), and ≦41% for X5; for the mannitol test, ≧18% in R5, ≧40% in AX, and ≦21% for X5. In the EVH test, ≧23% for R5, ≧40% for AX, and a fall of 29% for X5. When using the optimal cut‐off points obtained from IOS, the mean number of steps and doses required for methacholine and mannitol tests to induce significant bronchoconstriction were significantly lower compared with spirometry ( P < .05). Conclusions The effectiveness of R5, X5, and AX indexes were comparable to FEV1 in assessing bronchial obstruction during bronchial challenge testing. Therefore, IOS may be useful in assessing bronchial obstruction in children who cannot reliably perform spirometric maneuvers during bronchial challenge testing.

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Section: Discussionsupporting

confidence: 92%

Comparison of impulse oscillometry and spirometry for detection of airway hyperresponsiveness to methacholine, mannitol, and eucapnic voluntary hyperventilation in children

Jara-Gutierrez

Aguado

Potro

et al. 2019

Pediatric Pulmonology

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“…Bronchial challenge testing with direct (eg methacholine or histamine) (69, 70) or indirect acting (eg mannitol) (71) agents may be used in everyday clinical practice to identify the presence of airway hyperreactivity, which is the hallmark of persistent asthma, particularly useful when the diagnosis of asthma is in doubt as in cases of unexplained cough or lack of apparent response to escalating treatment.…”

Section: Assessing Airway Reactivitymentioning

confidence: 99%

“…18 adult patients with mild to moderate persistent asthma had methacholine and histamine challenges, measuring both spirometry and IOS (69) . A mean 23.3 (95% CI 18.7-27.9%) fall in FEV1 was associated with a mean 43.5 (95% CI 29.4-57.5%) increase in R5, all of which were significant.…”

Section: Assessing Airway Reactivitymentioning

confidence: 99%

The case for impulse oscillometry in the management of asthma in children and adults

Galant

Komarow

Shin

et al. 2017

Annals of Allergy, Asthma & Immunology

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128

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“…In asthma, a correlation has been demonstrated between disease severity and oscillometry measured small airway resistance . Small studies have also found oscillometry to be more sensitive than spirometry in detecting airway hyperreactivity after bronchoprovocation challenge, and comparable with spirometry in assessing bronchodilation in moderate asthma . These parameters also relate to asthma control even when the forced expiratory volume in 1 s (FEV 1 ) is normal …”

Section: Introductionmentioning

confidence: 99%

Measuring the effects of bronchial thermoplasty using oscillometry

et al. 2018

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Background and objective: Bronchial thermoplasty (BT) has been consistently shown to reduce symptoms, exacerbations and the need for reliever medication in patients with severe asthma. Paradoxically, no consistent improvement in spirometry has been demonstrated. It has been suggested that this is due to a reduction in peripheral resistance in small airways, not captured by spirometry. Therefore, in this study, we evaluate the response to BT using oscillometry. Methods: A total of 43 patients with severe asthma from two centres were evaluated at baseline, 6 weeks and 6 months post BT, using spirometry, plethysmography and oscillometry, in addition to medication usage, exacerbation frequency and the Asthma Control Questionnaire (5-item version) (ACQ-5). Results: The mean age was 58.4 AE 11.2 years, forced expiratory volume in 1 s (FEV 1 ) 55.5 AE 20.1% predicted, forced expiratory ratio 53.0 AE 14.5% and FEV 1 response to salbutamol was 14.0 AE 14.5%. Following BT, the group responded to treatment with an improvement in ACQ-5 from 2.9 AE 0.9 at baseline to 1.7 AE 1.1 at 6 months (P < 0.005). There was an 81% reduction in exacerbation frequency (P < 0.001) and 50% of patients were weaned completely from maintenance oral corticosteroids. No changes after treatment were observed in spirometry but the residual volume reduced from 147 AE 38% to 139 AE 39% predicted (P < 0.01). Baseline oscillometry demonstrated high levels of resistance at 5 Hz with normal resistance at 20 Hz, indicating resistance in the small airways was elevated, but no changes were observed in any oscillometry parameter after BT treatment. Conclusion: Lung impedance measured with oscillometry did not change following BT despite marked clinical improvements in patients with severe asthma.

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Usefulness of impulse oscillometry for the assessment of airway hyperresponsiveness in mild-to-moderate adult asthma

Cited by 27 publications

References 15 publications

Comparison of impulse oscillometry and spirometry for detection of airway hyperresponsiveness to methacholine, mannitol, and eucapnic voluntary hyperventilation in children

Comparison of impulse oscillometry and spirometry for detection of airway hyperresponsiveness to methacholine, mannitol, and eucapnic voluntary hyperventilation in children

The case for impulse oscillometry in the management of asthma in children and adults

Measuring the effects of bronchial thermoplasty using oscillometry

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