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August 10, 2020 / in Scientific Article

Abstract

Introduction/Aim

Bronchial Thermoplasty (BT) improves symptom control and reduces exacerbations in patients with refractory asthma. The precise mechanism remains unclear, but consistent improvement in spirometry has not been recorded. We postulate that assessment of lung function during tidal breathing with oscillometry to measure respiratory impedance may better reflect the clinical improvements reported.

Methods

Patients with refractory asthma (GINA Step 5) had the Asthma Control Questionnaire (ACQS), spirometry, resistance at 5 Hz (R5) and reactance at 5 Hz (X5) recorded before and 6 weeks after completing BT. One centre measured impedance with the forced oscillation technique (FOT) (TremoFlo C-100, Thorasys Medical Systems, Canada) and the other with impulse oscillometry (105) (Sensormedics).

Results

The average age was 60.8 (1.4) years in the FOT group and 61.2 (11.4 years in the lOS group. ACQS scores improved in both groups. In the FOT group, there were significant improvements in spirometry and X5; and the change in X5 correlated

The articles include uses of tremoflo products or describes research devices that may not have been cleared by FDA
Source

Farah C, Langton D, Pierucci P, Ing A. Changes in Lung Function and Forced Oscillatory Technique (FOT) Parameters Following Bronchial Thermoplasty (BT) in Patients with Refractory Asthma. Am J Respir Crit Care Med [Internet]. 2017;195:A6497

Other resources of interest

June 9, 2022
Longitudinal monitoring of asthma in the clinic using respiratory oscillometry
Asthma guidelines emphasize the importance of assessing lung function and symptoms. The forced oscillation technique (FOT) and its longitudinal relationship with spirometry and symptoms are unresolved. We examined concordance between longitudinal spirometry, FOT and symptom control, and determined FOT limits of agreement in stable asthma.
June 9, 2022
Criteria for Airway Oscillometry Reversibility in Asthma
We read with interest the article in the June 2020 issue of CHEST from Cottee et al,1 examining 52 patients with asthma, which concluded that bronchodilator response to albuterol 400 mg using forced oscillation technique (airway oscillometry [AO]) with Thorasys Tremoflo was more sensitive than spirometry at identifying poor disease control with the asthma control test.1 This pattern was observed for reactance area (AX) and reactance at 5Hz but not for resistance at 5Hz (R5).
May 2, 2022
Regional Airway Heterogeneity in Asthma
In an issue of CHEST (September 2020), Karakioulaki et al1 reinforced mounting evidence for the presence of regionally heterogeneous airway abnormalities in patients with asthma by showing histopathologic airway differences across lung lobes on endobronchial biopsy. At the lobar level, airway smooth muscle cell mass and the distance between the basement membrane and airway smooth muscle were significantly different across lobes. Airway smooth muscle cell mass was greater in lower lobes compared with upper lobes, and, although specific interlobar differences were not measured, the right upper lobe notably exhibited the least amount of airway smooth muscle mass.
June 9, 2022
Longitudinal monitoring of asthma in the clinic using respiratory oscillometry
Asthma guidelines emphasize the importance of assessing lung function and symptoms. The forced oscillation technique (FOT) and its longitudinal relationship with spirometry and symptoms are unresolved. We examined concordance between longitudinal spirometry, FOT and symptom control, and determined FOT limits of agreement in stable asthma.
June 9, 2022
Criteria for Airway Oscillometry Reversibility in Asthma
We read with interest the article in the June 2020 issue of CHEST from Cottee et al,1 examining 52 patients with asthma, which concluded that bronchodilator response to albuterol 400 mg using forced oscillation technique (airway oscillometry [AO]) with Thorasys Tremoflo was more sensitive than spirometry at identifying poor disease control with the asthma control test.1 This pattern was observed for reactance area (AX) and reactance at 5Hz but not for resistance at 5Hz (R5).
May 2, 2022
Regional Airway Heterogeneity in Asthma
In an issue of CHEST (September 2020), Karakioulaki et al1 reinforced mounting evidence for the presence of regionally heterogeneous airway abnormalities in patients with asthma by showing histopathologic airway differences across lung lobes on endobronchial biopsy. At the lobar level, airway smooth muscle cell mass and the distance between the basement membrane and airway smooth muscle were significantly different across lobes. Airway smooth muscle cell mass was greater in lower lobes compared with upper lobes, and, although specific interlobar differences were not measured, the right upper lobe notably exhibited the least amount of airway smooth muscle mass.
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