Clinical significance and applications of oscillometry

Cureus, 2023

Oscillometry, a non-invasive technique for assessing lung function, has gained significant recognition and importance in modern pulmonary medicine. This comprehensive review thoroughly explores its principles, applications, advantages, limitations, recent innovations, and future directions. Oscillometry's primary strength lies in its ability to offer a holistic assessment of lung mechanics. Unlike traditional spirometry, oscillometry captures the natural airflow during quiet breathing, making it suitable for patients of all ages and those with severe respiratory conditions. It provides a comprehensive evaluation of airway resistance, reactance, and compliance, offering insights into lung function that were previously challenging to obtain. In clinical practice, oscillometry finds extensive application in diagnosing and managing respiratory diseases. It plays a pivotal role in asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases. By detecting subtle changes in lung function before symptoms manifest, oscillometry facilitates early interventions, improving disease management and patient outcomes. Oscillometry's noninvasive and patient-friendly nature is precious in pediatric care, where traditional spirometry may be challenging for young patients. It aids in diagnosing and monitoring pediatric respiratory disorders, ensuring that children receive the care they need from an early age. Despite its many advantages, oscillometry faces challenges, such as the need for standardized protocols and the complexity of data interpretation. However, ongoing efforts to establish global standards and provide education and training for healthcare professionals aim to address these issues. Looking ahead, oscillometry holds great promise in the field of personalized medicine. With its ability to tailor treatment plans based on individualized lung function data, healthcare providers can optimize therapy selection and dosing, ultimately improving patient care and quality of life. In conclusion, oscillometry is poised to play an increasingly pivotal role in modern pulmonary medicine. As standardization efforts continue and technology evolves, it is an indispensable tool in the clinician's arsenal for diagnosing, managing, and personalizing respiratory care, ultimately leading to improved patient outcomes and better respiratory health.

Pediatric Pulmonology, 2011

Background: The impulse oscillation system (IOS) allows easy measurement of respiratory system impedance (Zrs). The aim of this retrospective study was to evaluate the accuracy of IOS parameters obtained during methacholine challenge by comparison with ''the gold standard'' forced expiratory volume in the first second (FEV 1 ). Methods: Measurements of FEV 1 and resistances at 5 and 20 Hz, reactance at 5 Hz, impedance at 5 Hz and resonant frequency were performed in 227 children with suspected asthma, before and during methacholine challenge. Data were analyzed in the overall population and in three subgroups according to the final diagnosis: asthma (n ¼ 72), chronic cough and nonspecific respiratory symptoms (n ¼ 122), allergic rhinitis (n ¼ 33). Results: All IOS parameters changed significantly during the tests but only changes in X5 were significantly different between responders and nonresponders. Moreover, changes in IOS parameters were not correlated with changes in FEV 1 apart from a weak correlation for X5. The receiver operating characteristic (ROC) curve for changes in X5 (to predict a 20% decrease in FEV 1 ) showed a best decision level for a 50% decrease in X5 with a sensitivity of 36% and a specificity of 85%. Results were not different in the asthma group. Conclusion: The accuracy of measurements by IOS during methacholine bronchial challenge in children was not suitable when compared with FEV 1 . It could be assumed that spirometry and IOS, while both providing indirect indices of airway patency, are exploring different mechanisms, each with its own methodological potentials and limitations.

European Respiratory Journal

Oscillometry (also known as the forced oscillation technique) measures the mechanical properties of the respiratory system (upper and intrathoracic airways, lung tissue and chest wall) during quiet tidal breathing, by the application of an oscillating pressure signal (input or forcing signal), most commonly at the mouth. With increased clinical and research use, it is critical that all technical details of the hardware design, signal processing and analyses, and testing protocols are transparent and clearly reported to allow standardisation, comparison and replication of clinical and research studies. Because of this need, an update of the 2003 European Respiratory Society (ERS) technical standards document was produced by an ERS task force of experts who are active in clinical oscillometry research.The aim of the task force was to provide technical recommendations regarding oscillometry measurement including hardware, software, testing protocols and quality control.The main changes...

Respiratory Medicine, 2007

Objective: To address the utility of the forced oscillation technique (FOT) in assessing bronchodilator responsiveness compared with forced expiratory volume in 1 s (FEV 1 ). Methods: This is a retrospective analysis of consecutive 126 patients with a clinical history of asthma without any other lung diseases at a pulmonary function testing laboratory. The following measurements were obtained three times each, before and after two doses of pirbuterol 0.2 mg inhalation: the respiratory resistance at 5 Hz (Rrs5), the mean respiratory resistance between 5 and 20 Hz (Rrs5-20), and the mean respiratory conductance (Grs5-20) by FOT and the FEV 1 by spirometer. These measurements were transformed into dimensionless subject-specific effect-size ''d-scores'' by dividing them by the estimated pooled within-subject standard deviation. Results: Descriptive statistics for each value were the following [mean baseline value (7SD), D value (pre-minus post value), and d-score (P value compared to FEV 1 )]: Grs5-20

Pediatric Pulmonology, 2012

Background-The ability to objectively measure lung function in children is critical in the assessment and treatment of asthma in this age group. We thus determined the effectiveness of impulse oscillometry (IOS) as a non-invasive technique to assess lung function in children and in comparison to spirometry for sensitivity and specificity, testing variability, and the order effect of sequential testing of IOS and spirometry.

Journal of Asthma, 2007

To explore the use of oscillometry as a measure of airway responsiveness, 69 asthmatic children underwent histamine and methacholine bronchoprovocation using dosimeter-MedicAid (Jaeger Co.; Germany) and DeVilbiss nebulizers (DeVilbiss, Bornemouth; England). The mean increase in R5 resistance in challenge testing measured after methacholine with the dosimeter-MedicAid nebulizer was 77.14% compared with 65.05% using histamine. Using the dosimeter-DeVilbiss nebulizer, the mean increases in R5 resistance following methacholine and histamine testing were 57.50% and 59.36%, respectively. The resistance R5 over R20 significantly correlated with forced expiratory volume in 1 second (FEV 1). The MedicAid produced a more aggressive challenge than the DeVilbliss nebulizer. Oscillometry can be used to monitor the level of airway hyperresponsiveness following bronchoprovocation tests.

Journal of Asthma, 2019

Objective: The forced oscillation technique (FOT) is a useful diagnostic respiratory system for children. However, the final value of the FOT in the diagnosis of bronchoconstriction is still open. The aim of the study was to evaluate the sensitivity and specificity of the FOT vs. body plethysmography tests in the measure of bronchoconstriction in asthmatic children. Materials and methods: A total of 102 children aged 2 to 6 years diagnosed with earlyonset asthma and 52 healthy controls were included in this prospective, randomized study. All asthmatic patients and healthy controls underwent a basic FOT as one measurement, according to the recommendation of the Resmon Pro FOT. Then, the reversibility test was performed 20 min after the administration of 200 mg salbutamol using the FOT and body plethysmography in all patients. Results: The mean basic Rrs, Xrs and sRaw in asthmatic patients were, respectively, 11.13 ± 1.28 kPa sL À1 , À4.6 ± 1.18 kPa sL À 1 and 1.72 ± 0.58 kPa s. Similar parameters were significantly better in the control group (p < 0.05). A total of 73 (71.6%) asthmatic patients had a positive test using the FOT according to Calogero. In 4 (7.7%) patients in the control group, a positive test was obtained. In body plethysmography, similar results were reached, with a positive test in 76 (74.5%) study patients and 5 (9.6%) control patients. Conclusions: A bronchial reversibility test with the use of the FOT is useful for the diagnosis of bronchial asthma, especially with the use of an Rrs parameter, such as the body plethysmography test.

Therapeutics and Clinical Risk Management, 2020

Over the past decades, impulse oscillometry (IOS) has gained ground in the battery of pulmonary function tests. Performing the test requires minimal cooperation of the patient; therefore, it is a useful tool, especially in evaluating lung mechanics in children, elderly patients, and those who cannot perform spirometry. Oscillometry has also been used in both clinical and research departments. Studies were published mainly in asthma regarding detection of bronchodilator response and the therapeutic response to different drugs. Furthermore, it has been shown to be a sensitive technique to evaluate disease control. Other studied diseases were COPD, interstitial lung diseases, small airway disease, impairment of lung function due to exposure to occupational hazards or smoking, central airways obstruction, cystic fibrosis, monitoring lung mechanics during mechanical ventilation and sleep, neuromuscular diseases, lung transplant, and graft function. The aim of this review is to present the utility of oscillometry on the previously mentioned clinical fields.

Current Pulmonology Reports, 2018

Purpose Chronic respiratory diseases are prevalent among adults and lung function testing is imperative for appropriate diagnosis and treatment. While spirometry is the standard measure of lung function, there exist groups of individuals unable to adequately perform accurate and reproducible lung function testing. Impedance oscillometry system (IOS) is an effort independent test that may be employed to assess airway function in challenging groups such as children and elderly. This review will compare IOS and spirometry and describe the physiologic measurements of lung function and interpretation strategies in adults with chronic airway disease. Recent Findings In adults with COPD, impedance oscillometry measurements of airway resistance correlate with the severity of airflow limitation measured with spirometry. In adults with asthma, IOS is a sensitive measure of airway hyperresponsiveness and bronchodilator response. Summary Impedance oscillometry is emerging, alternative method to assess lung function in adults.

Current allergy and asthma reports, 2018

Chronic respiratory diseases affecting adults and children are widely prevalent, so lung function testing is imperative for diagnosis and management. Spirometry is the traditional standard measure of lung function; however, certain groups of patients are unable to provide accurate and reproducible exhalation maneuvers. Consequently, the impedance oscillometry system (IOS) has been developed as an effort, independent technique to assess airway function in children and the elderly. To better understand this emerging modality, the following review will compare IOS with spirometry, examine the function of the device, provide interpretation strategies, and discuss the evidence supporting its use in adults and children with chronic lung disease. In a population of symptomatic adults with suspected COPD, impedance oscillometry resistance measurements correlate with FEV and lung resistance increases with the severity of airflow limitation. In patients with asthma, IOS is a sensitive measure...