Association Between Respiratory Impedance Measured by Forced Oscillation Technique and Exacerbations in Patients with COPD

Overview

Journal Int J Chron Obstruct Pulmon Dis

Publisher Dove Medical Press

Specialty Pulmonary Medicine

Date 2018 Jan 11

PMID 29317813

Citations 11

Authors

Hitomi Yamagami

Akihiko Tanaka

Yasunari Kishino

Hatsuko Mikuni

Tomoko Kawahara

Shin Ohta

Mayumi Yamamoto

Shintaro Suzuki

Tsukasa Ohnishi

Hironori Sagara

Affiliations

Soon will be listed here.

Abstract

Background: It is well known that increased airflow limitation as measured by spirometry is associated with the risk of exacerbation in patients with COPD. The forced oscillation technique (FOT) is a noninvasive method used to assess respiratory impedance (resistance and reactance) with minimal patient cooperation required. The clinical utility of the FOT in assessing the risk of exacerbations of COPD is yet to be determined. We examined the relationship between respiratory impedance as measured by FOT and exacerbations in patients with COPD.

Materials And Methods: Among 310 patients with COPD (Global Initiative for Chronic Obstructive Lung Disease stages I-IV) who presented at the outpatient clinic of the Showa University Hospital from September 2014 through January 2015, 119 were collected and assigned into 2 groups according to their history of exacerbation: exacerbators and nonexacerbators. Respiratory resistance components and respiratory reactance components, as measured by FOT, were compared between the two groups.

Results: Exacerbators were significantly older and had a higher white blood cell count than nonexacerbators. Resistance at 20 Hz, reactance at 5 Hz (X5), resonant frequency (Fres), and area of low reactance (ALX) differed significantly between the two groups. In addition, among patients with stage II COPD, there were significant differences in X5, Fres, and ALX between the two groups despite no significant differences in respiratory function as assessed by spirometry. Finally, receiver operating characteristic curve analysis revealed that the reactance components rather than the resistance components were associated with the risk of exacerbation.

Conclusion: There were significant differences in respiratory impedance between exacerbators and nonexacerbators in patients with moderate COPD. FOT is a promising tool for assessing future exacerbations in patients with COPD.

Citing Articles

Early Identification of Exacerbations in Patients with Chronic Obstructive Pulmonary Disease (COPD).

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Clinical characteristics of airway impairment assessed by impulse oscillometry in patients with chronic obstructive pulmonary disease: findings from the ECOPD study in China.

Lu L, Peng J, Wu F, Yang H, Zheng Y, Deng Z BMC Pulm Med. 2023; 23(1):52.

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Clinical significance and applications of oscillometry.

Kaminsky D, Simpson S, Berger K, Calverley P, de Melo P, Dandurand R Eur Respir Rev. 2022; 31(163).

PMID: 35140105 PMC: 9488764. DOI: 10.1183/16000617.0208-2021.

The clinical utility of forced oscillation technique during hospitalisation in patients with exacerbation of COPD.

Alqahtani J, Al Rajeh A, Aldhahir A, Aldabayan Y, Hurst J, Mandal S ERJ Open Res. 2021; 7(4).

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References

Borrill Z, Houghton C, Woodcock A, Vestbo J, Singh D . Measuring bronchodilation in COPD clinical trials. Br J Clin Pharmacol. 2005; 59(4):379-84. PMC: 1884799. DOI: 10.1111/j.1365-2125.2004.02261.x. View

Houghton C, Woodcock A, Singh D . A comparison of plethysmography, spirometry and oscillometry for assessing the pulmonary effects of inhaled ipratropium bromide in healthy subjects and patients with asthma. Br J Clin Pharmacol. 2005; 59(2):152-9. PMC: 1884751. DOI: 10.1111/j.1365-2125.2004.2262.x. View

Han M, Kazerooni E, Lynch D, Liu L, Murray S, Curtis J . Chronic obstructive pulmonary disease exacerbations in the COPDGene study: associated radiologic phenotypes. Radiology. 2011; 261(1):274-82. PMC: 3184233. DOI: 10.1148/radiol.11110173. View

Aoki M, Osanai S, Ogasa T, Yamazaki N, Ishida K, Nakata H . [Comparison between predicted equations obtained by standard Japanese values and present predicted equations for vital capacity and forced expiratory volume in one second]. Nihon Kokyuki Gakkai Zasshi. 2010; 48(5):357-63. View

Goldman M, Saadeh C, Ross D . Clinical applications of forced oscillation to assess peripheral airway function. Respir Physiol Neurobiol. 2005; 148(1-2):179-94. DOI: 10.1016/j.resp.2005.05.026. View

Soler-Cataluna J, Martinez-Garcia M, Roman Sanchez P, Salcedo E, Navarro M, Ochando R . Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax. 2005; 60(11):925-31. PMC: 1747235. DOI: 10.1136/thx.2005.040527. View

Di Mango A, Lopes A, Jansen J, Melo P . Changes in respiratory mechanics with increasing degrees of airway obstruction in COPD: detection by forced oscillation technique. Respir Med. 2005; 100(3):399-410. DOI: 10.1016/j.rmed.2005.07.005. View

Tomioka R, Kawayama T, Suetomo M, Kinoshita T, Tokunaga Y, Imaoka H . "Frequent exacerbator" is a phenotype of poor prognosis in Japanese patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2016; 11:207-16. PMC: 4745858. DOI: 10.2147/COPD.S98205. View

Gonem S, Umar I, Burke D, Desai D, Corkill S, Owers-Bradley J . Airway impedance entropy and exacerbations in severe asthma. Eur Respir J. 2012; 40(5):1156-63. DOI: 10.1183/09031936.00228611. View

10.

Jones P, Brusselle G, Dal Negro R, Ferrer M, Kardos P, Levy M . Health-related quality of life in patients by COPD severity within primary care in Europe. Respir Med. 2010; 105(1):57-66. DOI: 10.1016/j.rmed.2010.09.004. View

11.

Nielsen M, Barnes C, Ulrik C . Clinical characteristics of the asthma-COPD overlap syndrome--a systematic review. Int J Chron Obstruct Pulmon Dis. 2015; 10:1443-54. PMC: 4524387. DOI: 10.2147/COPD.S85363. View

12.

Hurst J, Vestbo J, Anzueto A, Locantore N, Mullerova H, Tal-Singer R . Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010; 363(12):1128-38. DOI: 10.1056/NEJMoa0909883. View

13.

Llor C, Molina J, Naberan K, Cots J, Ros F, Miravitlles M . Exacerbations worsen the quality of life of chronic obstructive pulmonary disease patients in primary healthcare. Int J Clin Pract. 2008; 62(4):585-92. DOI: 10.1111/j.1742-1241.2008.01707.x. View

14.

Sundh J, Johansson G, Larsson K, Linden A, Lofdahl C, Sandstrom T . The phenotype of concurrent chronic bronchitis and frequent exacerbations in patients with severe COPD attending Swedish secondary care units. Int J Chron Obstruct Pulmon Dis. 2015; 10:2327-34. PMC: 4630179. DOI: 10.2147/COPD.S91362. View

15.

Tse H, Tseng C, Wong K, Yee K, Ng L . Accuracy of forced oscillation technique to assess lung function in geriatric COPD population. Int J Chron Obstruct Pulmon Dis. 2016; 11:1105-18. PMC: 4887060. DOI: 10.2147/COPD.S102222. View

16.

Mikamo M, Shirai T, Mori K, Shishido Y, Akita T, Morita S . Predictors of expiratory flow limitation measured by forced oscillation technique in COPD. BMC Pulm Med. 2014; 14:23. PMC: 3936701. DOI: 10.1186/1471-2466-14-23. View

17.

Mori K, Shirai T, Mikamo M, Shishido Y, Akita T, Morita S . Colored 3-dimensional analyses of respiratory resistance and reactance in COPD and asthma. COPD. 2011; 8(6):456-63. DOI: 10.3109/15412555.2011.626818. View

18.

Menezes A, Montes de Oca M, Perez-Padilla R, Nadeau G, Wehrmeister F, Lopez-Varela M . Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype: COPD-asthma. Chest. 2013; 145(2):297-304. DOI: 10.1378/chest.13-0622. View

19.

Burgel P, Nesme-Meyer P, Chanez P, Caillaud D, Carre P, Perez T . Cough and sputum production are associated with frequent exacerbations and hospitalizations in COPD subjects. Chest. 2008; 135(4):975-982. DOI: 10.1378/chest.08-2062. View

20.

Kolsum U, Borrill Z, Roy K, Starkey C, Vestbo J, Houghton C . Impulse oscillometry in COPD: identification of measurements related to airway obstruction, airway conductance and lung volumes. Respir Med. 2008; 103(1):136-43. DOI: 10.1016/j.rmed.2008.07.014. View