scholarly journals The Clinical Utility of Forced Oscillation Technique (FOT) during Hospitalisation in patients with exacerbation of COPD

2021 ◽  
pp. 00448-2021
Author(s):  
Jaber S. Alqahtani ◽  
Ahmad M. Al Rajeh ◽  
Abdulelah M. Aldhahir ◽  
Yousef S. Aldabayan ◽  
John R. Hurst ◽  
...  
Keyword(s):  
Supine Position ◽  
Forced Oscillation ◽  
Airflow Limitation ◽  
Forced Oscillation Technique ◽  
Clinical Value ◽  
Expiratory Flow Limitation ◽  
Copd Patients ◽  
Patient Reported ◽  
Independent Technique ◽  
Exacerbation Of Copd

BackgroundForced Oscillation Technique (FOT) is an innovative tool to measure within-breath reactance at 5 Hz (ΔXrs5Hz) but its feasibility and utility in acute exacerbations of COPD (AECOPD) is understudied.MethodsA prospective observational study was conducted in 82 COPD patients admitted due to AECOPD. FOT indices were measured and the association between these indices and spirometry, peak inspiratory flow rate, blood inflammatory biomarkers and patient-reported outcomes including assessment of dyspnoea, quality of life; anxiety and depression and frailty at admission and discharge were explored.ResultsAll patients were able to perform FOT in both sitting and supine position. The prevalence of expiratory flow limitation (EFL) in the upright position was 39% (32/82) and increased to 50% (41/82) in the supine position. EFL (measured by ΔXrs5Hz) and resistance at 5 Hz (Rrs5Hz) negatively correlated with FEV1; those with EFL had lower FEV1 (0.74±0.30 versus 0.94±0.36 L, p=0.01) and FVC (1.7 ±0.55 versus 2.1 ±0.63 L, p= 0.009) and higher BMI [27 (21–36) versus 23 (19–26) kg/m2, p=0.03] compared to those without EFL. During recovery from AECOPD, changes in EFL was observed in association with improvement in breathlessness.ConclusionFOT was easily used to detect EFL during hospitalisation due to AECOPD. The prevalence of EFL increased when patients moved from a seated to a supine position and EFL was negatively correlated with airflow limitation. Improvements in EFL were associated with a reduction in breathlessness. FOT is of potential clinical value by providing a non-invasive, objective, and effort-independent technique to measure lung function parameters during AECOPD requiring hospital admission.

scholarly journals Variability of within-breath reactance in COPD patients and its association with dyspnoea

2014 ◽  
Vol 45 (3) ◽  
pp. 625-634 ◽  
Author(s):  
Bernt B. Aarli ◽  
Peter M.A. Calverley ◽  
Robert L. Jensen ◽  
Tomas M.L. Eagan ◽  
Per S. Bakke ◽  
...  
Keyword(s):  
Continuous Measurement ◽  
Medical Research Council ◽  
Forced Oscillation ◽  
Chronic Obstructive ◽  
Forced Oscillation Technique ◽  
Flow Limitation ◽  
Oscillation System ◽  
Expiratory Flow Limitation ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

The forced oscillation technique can identify expiratory flow limitation (EFL) when a large difference in inspiratory and expiratory reactance (ΔXrs) occurs. However, flow limitation can vary from breath to breath, and so we compared a multiple-breath ΔXrs approach to the traditional breath-by-breath assessment of EFL. We investigated the within- and between-day reproducibility and the factors that affect the size of ΔXrs when used as a continuous measurement over multiple breaths. In addition, we examined how multiple-breath ΔXrs relates to the sensation of breathlessness.425 moderate to very severe chronic obstructive pulmonary disease (COPD) patients and 229 controls were included. Spirometry and impedance measurements were performed on a MasterScope CT Impulse Oscillation System.Median ΔXrs approached zero in healthy controls with little variation between measurements. COPD patients generally had higher ΔXrs and higher variability. The COPD patients with ΔXrs >0.1 kPa·L−1·s−1 were prone to be more breathless and had a higher modified Medical Research Council dyspnoea scale score. In controls, the 95th percentile of ΔXrs was as low as 0.07 kPa·L−1·s−1.We describe a new method to assess EFL at a patient level and propose a cut-off, mean ΔXrs >0.1 kPa·L−1·s−1, as a way to identify COPD patients who are more likely to report dyspnoea.

scholarly journals Airway dynamics in COPD patients by within-breath impedance tracking: effects of continuous positive airway pressure

2017 ◽  
Vol 49 (2) ◽  
pp. 1601270 ◽  
Author(s):  
András Lorx ◽  
Dorottya Czövek ◽  
Zoltán Gingl ◽  
Gergely Makan ◽  
Bence Radics ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Forced Oscillation Technique ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Large Variability ◽  
Normal Breathing ◽  
Copd Patients ◽  
Expiratory Flow

Tracking of the within-breath changes of respiratory mechanics using the forced oscillation technique may provide outcomes that characterise the dynamic behaviour of the airways during normal breathing.We measured respiratory resistance (Rrs) and reactance (Xrs) at 8 Hz in 55 chronic obstructive pulmonary disease (COPD) patients and 20 healthy controls, and evaluated Rrs and Xrs as functions of gas flow (V′) and volume (V) during normal breathing cycles. In 12 COPD patients, additional measurements were made at continuous positive airway pressure (CPAP) levels of 4, 8, 14 and 20 hPa.The Rrs and Xrsversus V′ and V relationships displayed a variety of loop patterns, allowing characterisation of physiological and pathological processes. The main outcomes emerging from the within-breath analysis were the Xrsversus V loop area (AXV) quantifying expiratory flow limitation, and the tidal change in Xrs during inspiration (ΔXI) reflecting alteration in lung inhomogeneity in COPD. With increasing CPAP, AXV and ΔXI approached the normal ranges, although with a large variability between individuals, whereas mean Rrs remained unchanged.Within-breath tracking of Rrs and Xrs allows an improved assessment of expiratory flow limitation and functional inhomogeneity in COPD; thereby it may help identify the physiological phenotypes of COPD and determine the optimal level of respiratory support.

scholarly journals Detection of expiratory flow limitation in COPD using the forced oscillation technique

2004 ◽  
Vol 23 (2) ◽  
pp. 232-240 ◽  
Author(s):  
R.L. Dellacà ◽  
P. Santus ◽  
A. Aliverti ◽  
N. Stevenson ◽  
S. Centanni ◽  
...  
Keyword(s):  
Forced Oscillation ◽  
Forced Oscillation Technique ◽  
Flow Limitation ◽  
Expiratory Flow Limitation ◽  
Expiratory Flow

scholarly journals Long-term change in reactance by forced oscillation technique correlates with FEV1 decline in moderate COPD patients

2017 ◽  
Vol 49 (4) ◽  
pp. 1601534 ◽  
Author(s):  
Takefumi Akita ◽  
Toshihiro Shirai ◽  
Taisuke Akamatsu ◽  
Mika Saigusa ◽  
Akito Yamamoto ◽  
...  
Keyword(s):  
Forced Oscillation ◽  
Forced Oscillation Technique ◽  
Copd Patients ◽  
Term Change ◽  
Fev1 Decline

scholarly journals Distinct Mechanical Properties of the Respiratory System Evaluated by Forced Oscillation Technique in Acute Exacerbation of COPD and Acute Decompensated Heart Failure

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 554
Author(s):  
Silvia Terraneo ◽  
Rocco Francesco Rinaldo ◽  
Giuseppe Francesco Sferrazza Papa ◽  
Fulvia Ribolla ◽  
Carlo Gulotta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mechanical Properties ◽  
Acute Exacerbation ◽  
Respiratory System ◽  
Forced Oscillation ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Forced Oscillation Technique ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

Discriminating between cardiac and pulmonary dyspnea is essential for patients’ management. We investigated the feasibility and ability of forced oscillation techniques (FOT) in distinguishing between acute exacerbation of COPD (AECOPD), and acute decompensated heart failure (ADHF) in a clinical emergency setting. We enrolled 49 patients admitted to the emergency department (ED) for dyspnea and acute respiratory failure for AECOPD, or ADHF, and 11 healthy subjects. All patients were able to perform bedside FOT measurement. Patients with AECOPD showed a significantly higher inspiratory resistance at 5 Hz, Xrs5 (179% of predicted, interquartile range, IQR 94–224 vs. 100 IQR 67–149; p = 0.019), and a higher inspiratory reactance at 5 Hz (151%, IQR 74–231 vs. 57 IQR 49–99; p = 0.005) than patients with ADHF. Moreover, AECOPD showed higher heterogeneity of ventilation (respiratory system resistance difference at 5 and 19 Hz, Rrs5-19: 1.49 cmH2O/(L/s), IQR 1.03–2.16 vs. 0.44 IQR 0.22–0.76; p = 0.030), and a higher percentage of flow limited breaths compared to ADHF (10%, IQR 0–100 vs. 0 IQR 0–12; p = 0.030). FOT, which resulted in a suitable tool to be used in the ED setting, has the ability to identify distinct mechanical properties of the respiratory system in AECOPD and ADHF.

Sign in / Sign up

Export Citation Format

Share Document