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May 6, 2020 / in Scientific Article

Abstract

BACKGROUND

With several commercially available devices measuring respiratory impedance by oscillometry, the agreement between values obtained on different instruments or frequencies remains unclear. Our aim was to examine the agreement between resistance and reactance parameters on two oscillometry instruments using different waveforms.

METHODS

We conducted a prospective cross-sectional study in asthmatic children aged 3–17 years. Reproducible oscillometry measurements were obtained in random order, by blinded operators, at three modes: 5–10–15–20–25 Hz (5–25 Hz) multifrequency mode on the MasterScreen impulse oscillometry system, and both 5–25 Hz multifrequency mode and 7 Hz monofrequency on the tremoFlo C-100 airwave sinusoidal system. Resistance, reactance and within-breath parameters were examined using the intraclass correlation coefficient (ICC), paired t-test, linear regression and Bland–Altman method.

RESULTS

Of 50 participants, 44 and 38 completed between-device and within-frequency measurements, respectively. Between-device measurements at 5–25 Hz showed high (ICC 0.88–0.91) and good (ICC 0.69–0.87) agreement in resistance and reactance, respectively, but with an absolute within-patient difference (≥0.05 kPa·L−1·s−1) and proportional bias (≥30% per kPa·L−1·s−1) in all parameters and oscillatory frequencies, apart from resistance at 5 Hz. A significant proportional bias was documented in most within-breath parameters at 5 versus 7 Hz on tremoFlo.

CONCLUSIONS

Observed differences in resistance and reactance suggest the need for instrument- and frequency-specific paediatric normative values.

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

Ducharme FM, Jroundi I, Jean G, Boutin GL, Lawson C, Vinet B. Interdevice agreement in respiratory resistance values by oscillometry in asthmatic children. ERJ Open Resv. 2019;5:.

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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