scholarly journals Impulse Oscillometry May Be Useful in Evaluation of Bronchiectasis Severity and Prediction of Airway Reversibility.

2021 ◽  
Author(s):  
Cuiyan Tan ◽  
Donghai Ma ◽  
Kongqiu Wang ◽  
Changli Tu ◽  
Meizhu Chen ◽  
...  
Keyword(s):  
Airway Resistance ◽  
Severe Disease ◽  
Peripheral Resistance ◽  
Roc Curves ◽  
Small Airways ◽  
Impulse Oscillometry ◽  
Airway Diseases ◽  
The Difference ◽  
Obstructive Airway Diseases ◽  
Airway Reversibility

Abstract BackgroundImpulse oscillometry (IOS) can be used to evaluateairway impedance in patients with obstructive airway diseases. Previous studies have demonstrated that IOS parameters differ betweenbronchiectasis patients and healthy controls. This study aims to explore the usefulness of IOS in assessing disease severity and airway reversibility in bronchiectasis.MethodSeventy-four patients with non-cystic fibrosis bronchiectasis who visited our Respiratory Medicine outpatient clinic were consecutively recruited. Spirometry, plethysmography and IOS tests were performed. Patients were stratified into mild, moderate and severe disease according to Reiff, Bhalla, BSI, FACED, and BRICS scores. Airway reversibility was measured by bronchodilation test (BDT) and the result was classified as positive or negative.. ROC curves of IOS parameters was used to assess the usefulness of IOS parameters in predicting airway reversibility. Correlations between the IOS, spirometric lung function and bronchiectasis severity parameters were analysed.ResultsMany IOS parameters, such as airway resistance at 5Hz (R5), small airways resistance (R5–R20), total airway reactance (X5), resonance frequency (Fres), total airway impedance at 5Hz (Z5), and peripheral resistance (Rp) increased with increased bronchiectasis severity according to the FACED, BSI and Reiff scores. Large airway resistance (R20) and central resistance (Rc) were not significantly different among groups with differentbronchiectasis severity. The difference between R5 and R20 (R5-R20) showed 81.0% sensitivity, and 69.8%specificity in predicting the airway reversibility in bronchiectasis with AUC of 0.794 (95%CI, 0.672-0.915).ConclusionIOS measurements are useful indicators of bronchiectasis severity and may be useful for predicting the airway reversibility.

Pulmonary impedance in dogs measured by forced random noise with a retrograde catheter

1982 ◽  
Vol 52 (3) ◽  
pp. 725-733 ◽  
Author(s):  
J. M. Fullton ◽  
D. A. Hayes ◽  
R. L. Pimmel
Keyword(s):  
Endotracheal Tube ◽  
Airway Resistance ◽  
Random Noise ◽  
Peripheral Resistance ◽  
Base Line ◽  
The Mean ◽  
The Difference ◽  
Central Airway

Retrograde catheter and forced random noise techniques were combined to study the distribution of resistance and compliance in dogs following the inhalation of aerosols containing 2.5 and 5.0 mg/ml of histamine. Mean base-line peripheral resistance was 0.367 cmH2O . l'1 . s, agreeing with previous estimates. After correction for the endotracheal tube, the mean central airway resistance was 0.040 cmH2O . l'1 . s, considerably lower than previous estimates. This discrepancy was attributed to an overcorrection for the endotracheal tube resistance. The lower histamine dose caused a substantial increase in peripheral resistance, a relatively small increase in central resistance, and substantial decreases in total and peripheral compliance. After the higher histamine dose, changes in peripheral resistance and both compliances were similar to those obtained with the lower dose; however, the increase in central resistance was much larger than at the lower dose. The difference between total and peripheral compliance yielded estimates of airway compliance of 0.00306 l/cmH2O before and 0.00104 l/cmH2O after 2.5 mg/ml of histamine.

scholarly journals Bronchodilator Response Assessment of the Small Airways Obstructive Pattern

2017 ◽  
Vol 11 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Plamen Bokov ◽  
Clémence Martin ◽  
Sémia Graba ◽  
Karine Gillet-Juvin ◽  
Mohamed Essalhi ◽  
...  
Keyword(s):  
Lower Limit ◽  
Pulmonary Function Tests ◽  
Response Assessment ◽  
Small Airways ◽  
Impulse Oscillometry ◽  
Bronchodilator Response ◽  
Airway Assessment ◽  
The Difference ◽  
Low Sensitivity ◽  
Lower Limit Of Normal

Background: A concomitant decrease in FEV1 and FVC with normal FEV1/FVC ratio and TLC defines small airways obstructive pattern (SAOP) and constitutes a classic pitfall of pulmonary-function-tests interpretation. Objective: To evaluate the prevalence of flow- (FEV1 increase≥12% and 200 mL), volume- (FVC or inspiratory capacity [IC] increase≥12% and 200 mL), flow and volume-, and non-response to bronchodilation in patients with SAOP. An additional objective was to assess whether impulse oscillometry (IOS) parameters allow the diagnosis of SAOP and its reversibility. Methods: Fifty consecutive adult patients with SAOP (FEV1 and FVC < lower limit of normal, FEV1/FVC and TLC > lower limit of normal) diagnosed on spirometry and plethysmography underwent the assessment of reversibility (400 µg salbutamol) on FEV1, FVC, IC and IOS parameters. Results: The diseases most frequently associated with SAOP were COPD and asthma (26 and 15 patients, respectively). Six patients were flow-responders, 20 were volume-responders, 9 were flow and volume-responders and 15 patients were non-responders. Overall, 26 patients had a significant improvement of IC, and 35 / 50 (70%, 95%CI: 57-83) exhibited a significant bronchodilator response. The difference between Rrs5Hz and Rrs20Hz was increased in 28/50 patients (56%, 95%CI: 42-70 with value higher than upper limit of normal) and its decrease after bronchodilator significantly correlated to FEV1 increase only, suggesting proximal airway assessment. Conclusion: A significant reversibility, mainly assessed on IC increase, is frequent in Small Airways Obstructive Pattern. Impulse oscillometry is of limited value in this context because of its low sensitivity.

Increased prevalence of small airways dysfunction in patients with systemic sclerosis as determined by impulse oscillometry

Rheumatology ◽  
2019 ◽  
Author(s):  
Martina Bonifazi ◽  
Nicola Sverzellati ◽  
Eva Negri ◽  
Giovanni Pomponio ◽  
Valeria Seletti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Low Frequency ◽  
Small Airways ◽  
Impulse Oscillometry ◽  
Therapeutic Implications ◽  
Radiological Features ◽  
Related Quality ◽  
St George's Respiratory Questionnaire ◽  
The Difference

Abstract Objectives The prevalence and clinical implications of small airways involvement in SSc are still to be fully elucidated. The goal of the present work is to assess the prevalence of small airways dysfunction by impulse oscillometry and to determine whether it correlates with selected disease-related features and respiratory-related quality of life. Methods Ninety-four SSc patients and 93 healthy controls were studied by impulse oscillometry measurements. Small airways dysfunction was defined as the difference between resistance at low frequency, i.e. 5 Hz, and resistance at high frequency, i.e. 20 Hz, termed ‘R5-R20’, ⩾0.07 kPa/l/s. The St George’s Respiratory Questionnaire was used to measure health impairment in SSc patients. Radiological features of small airways disease and parenchymal abnormalities on high resolution CT chest scans were jointly assessed by two thoracic radiologists. Results Small airways dysfunction was present in 21.5% of the SSc patient cohort, with a prevalence almost 5-fold higher compared with controls, and it was significantly associated with worse respiratory-related quality of life. Radiological features consistent with small airways abnormalities were detected in 25% of SSc patients, mostly in the absence of interstitial lung changes. Combining functional and radiological evaluations, one-third of the SSc cohort showed at least one feature of small airways involvement, which was associated with the lcSSc phenotype and with longer disease duration. Conclusion The current study strengthens the hypothesis that small airway dysfunction might be a feature of SSc-related lung involvement, providing the first data on its significant impact on respiratory-related quality of life. A full assessment of lung function in SSc patients should include impulse oscillometry as a complementary technique, due to potential clinical and therapeutic implications.

scholarly journals The Effect of Obesity on Asthma: Lung Function Analysis Using the Impulse Oscillometry in School-age Children

2020 ◽  
Author(s):  
Zeynep Güleç
Keyword(s):  
Lung Function ◽  
Airway Resistance ◽  
Function Analysis ◽  
School Age Children ◽  
School Age ◽  
Impulse Oscillometry ◽  
Lung Functions ◽  
Peripheral Airway ◽  
The Difference ◽  
Mold Exposure

INTRODUCTION: Studies investigating the lung function of school-age obese asthmatics are rare. The purpose of this study was to compare lung functions in school-age obese asthmatics with non-obese asthmatics. METHODS: Ninety-two children were assigned to obese asthmatics (OA group, n=43) and non-obese asthmatics (A group, n=49) groups. A baseline impulse oscillometry test was performed to measure lung functions. RESULTS: Baseline percent predicted value of R20 (p=0.025), R5-20 (p=0.040), and Fres (p=0.018) were significantly increased in obese asthmatics than non-obese asthmatics. AX was also higher in obese asthmatics compared to non-obese asthmatics, however, the difference was insignificant (p=0.787). Percent predicted value of R5 (p=0.007) and R10 (p=0.017) were higher in atopic than non-atopic obese asthmatics. Percent predicted value of R5 was higher in exercise-intolerant than exercise-tolerant non-obese asthmatics (p=0.045). Additionally, R10 was higher in non-obese asthmatics with household mold exposure than that without household mold exposure (p=0.045). The z scores of BMI or weight were correlated with none of the IOS parameters (p>0.05). DISCUSSION AND CONCLUSION: Main bronchial and peripheral airway resistance were higher in school-age obese asthmatics compared to non-obese asthmatics. Peripheral airway resistance was higher in atopic obese asthmatics as well as in exercise intolerant asthmatic children and those with household mold exposure.

scholarly journals Impulse oscillometry for detection of small airway dysfunction in subjects with chronic respiratory symptoms and preserved pulmonary function

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Liang-Yuan Li ◽  
Tian-Sheng Yan ◽  
Jing Yang ◽  
Yu-Qi Li ◽  
Lin-Xi Fu ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Respiratory Symptoms ◽  
Early Stage ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Small Airway ◽  
Impulse Oscillometry ◽  
Additional Method ◽  
Cutoff Values ◽  
Higher Sensitivity

Abstract Background Subjects with chronic respiratory symptoms and preserved pulmonary function (PPF) may have small airway dysfunction (SAD). As the most common means to detect SAD, spirometry needs good cooperation and its reliability is controversial. Impulse oscillometry (IOS) may complete the deficiency of spirometry and have higher sensitivity. We aimed to explore the diagnostic value of IOS to detect SAD in symptomatic subjects with PPF. Methods The evaluation of symptoms, spirometry and IOS results in 209 subjects with chronic respiratory symptoms and PPF were assessed. ROC curves of IOS to detect SAD were analyzed. Results 209 subjects with chronic respiratory symptoms and PPF were included. Subjects who reported sputum had higher R5–R20 and Fres than those who didn’t. Subjects with dyspnea had higher R5, R5–R20 and AX than those without. CAT and mMRC scores correlated better with IOS parameters than with spirometry. R5, R5–R20, AX and Fres in subjects with SAD (n = 42) significantly increased compared to those without. Cutoff values for IOS parameters to detect SAD were 0.30 kPa/L s for R5, 0.015 kPa/L s for R5–R20, 0.30 kPa/L for AX and 11.23 Hz for Fres. Fres has the largest AUC (0.665, P = 0.001) among these parameters. Compared with spirometry, prevalence of SAD was higher when measured with IOS. R5 could detect the most SAD subjects with a prevalence of 60.77% and a sensitivity of 81% (AUC = 0.659, P = 0.002). Conclusion IOS is more sensitive to detect SAD than spirometry in subjects with chronic respiratory symptoms and PPF, and it correlates better with symptoms. IOS could be an additional method for SAD detection in the early stage of diseases.

scholarly journals Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jonás Carmona-Pírez ◽  
Beatriz Poblador-Plou ◽  
Ignatios Ioakeim-Skoufa ◽  
Francisca González-Rubio ◽  
Luis Andrés Gimeno-Feliú ◽  
...  
Keyword(s):  
Substance Use ◽  
Chronic Conditions ◽  
Large Scale ◽  
Mental Health Problems ◽  
Epidemiological Studies ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Airway Diseases ◽  
Obstructive Sleep ◽  
Obstructive Airway Diseases

AbstractChronic obstructive airway diseases such as chronic obstructive pulmonary disease (COPD), asthma, rhinitis, and obstructive sleep apnea (OSA) are amongst the most common treatable and preventable chronic conditions with high morbidity burden and mortality risk. We aimed to explore the existence of multimorbidity clusters in patients with such diseases and to estimate their prevalence and impact on mortality. We conducted an observational retrospective study in the EpiChron Cohort (Aragon, Spain), selecting all patients with a diagnosis of allergic rhinitis, asthma, COPD, and/or OSA. The study population was stratified by age (i.e., 15–44, 45–64, and ≥ 65 years) and gender. We performed cluster analysis, including all chronic conditions recorded in primary care electronic health records and hospital discharge reports. More than 75% of the patients had multimorbidity (co-existence of two or more chronic conditions). We identified associations of dermatologic diseases with musculoskeletal disorders and anxiety, cardiometabolic diseases with mental health problems, and substance use disorders with neurologic diseases and neoplasms, amongst others. The number and complexity of the multimorbidity clusters increased with age in both genders. The cluster with the highest likelihood of mortality was identified in men aged 45 to 64 years and included associations between substance use disorder, neurologic conditions, and cancer. Large-scale epidemiological studies like ours could be useful when planning healthcare interventions targeting patients with chronic obstructive airway diseases and multimorbidity.

scholarly journals Differences in coagulopathy indices in patients with severe versus non-severe COVID-19: a meta-analysis of 35 studies and 6427 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alberto Polimeni ◽  
Isabella Leo ◽  
Carmen Spaccarotella ◽  
Annalisa Mongiardo ◽  
Sabato Sorrentino ◽  
...  
Keyword(s):  
Platelet Count ◽  
Meta Analysis ◽  
Severe Disease ◽  
Coagulation Factors ◽  
Primary Analysis ◽  
Severe Group ◽  
Intravascular Coagulopathy ◽  
The Difference ◽  
D Dimer

AbstractCoronavirus disease 2019 (COVID-19) is a highly contagious disease that appeared in China in December 2019 and spread rapidly around the world. Several patients with severe COVID-19 infection can develop a coagulopathy according to the ISTH criteria for disseminated intravascular coagulopathy (DIC) with fulminant activation of coagulation, resulting in widespread microvascular thrombosis and consumption of coagulation factors. We conducted a meta-analysis in order to explore differences in coagulopathy indices in patients with severe and non-severe COVID-19. An electronic search was performed within PubMed, Google Scholar and Scopus electronic databases between December 2019 (first confirmed Covid-19 case) up to April 6th, 2020. The primary endpoint was the difference of D-dimer values between Non-Severe vs Severe disease and Survivors vs Non-Survivors. Furthermore, results on additional coagulation parameters (platelet count, prothrombin time, activated partial thromboplastin time) were also analyzed. The primary analysis showed that mean d-dimer was significantly lower in COVID-19 patients with non-severe disease than in those with severe (SMD − 2.15 [− 2.73 to − 1.56], I2 98%, P < 0.0001). Similarly, we found a lower mean d-dimer in Survivors compared to Non-Survivors (SMD − 2.91 [− 3.87 to − 1.96], I2 98%, P < 0.0001). Additional analysis of platelet count showed higher levels of mean PLT in Non-Severe patients than those observed in the Severe group (SMD 0.77 [0.32 to 1.22], I2 96%, P < 0.001). Of note, a similar result was observed even when Survivors were compared to Non-Survivors (SMD 1.84 [1.16 to 2.53], I2 97%, P < 0.0001). Interestingly, shorter mean PT was found in both Non-Severe (SMD − 1.34 [− 2.06 to − 0.62], I2 98%, P < 0.0002) and Survivors groups (SMD − 1.61 [− 2.69 to − 0.54], I2 98%, P < 0.003) compared to Severe and Non-Survivor patients. In conclusion, the results of the present meta-analysis demonstrate that Severe COVID-19 infection is associated with higher D-dimer values, lower platelet count and prolonged PT. This data suggests a possible role of disseminated intravascular coagulation in the pathogenesis of COVID-19 disease complications.

scholarly journals The Influence of Air Pollution on the Development of Allergic Inflammation in the Airways in Krakow’s Atopic and Non-Atopic Residents

2021 ◽  
Vol 10 (11) ◽  
pp. 2383
Author(s):  
Ewa Czarnobilska ◽  
Małgorzata Bulanda ◽  
Daniel Bulanda ◽  
Marcel Mazur
Keyword(s):  
Air Pollution ◽  
Pearson Correlation ◽  
Birch Pollen ◽  
Allergic Inflammation ◽  
Control Group ◽  
Airway Diseases ◽  
Birch Pollen Allergen ◽  
Blood Basophil ◽  
Simultaneous Activation ◽  
The Difference

Until now, the simultaneous influence of air pollution assessed by measuring the objective marker of exposition (1-hydroxypirene, 1-OHP) and atopy on the development of allergic airway diseases has not been studied. The aim of this study was to determine the pathomechanism of the allergic response to PM2.5 in atopic and non-atopic patients. We investigated the changes in peripheral blood basophil activity of patients after stimulation with the birch pollen allergen alone, the allergen combined with PM2.5 (BP), PM2.5 alone, a concentration of 1-OHP in urine, and a distance of residence from the main road in 30 persons. Activation by dust alone was positive for all concentrations in 83% of atopic and 75% of non-atopic assays. In the group of people with atopy, the simultaneous activation of BP gave a higher percentage of active basophils compared to the sum of activation with dust and birch pollen alone (B + P) for all concentrations. The difference between BP and B + P was 117.5 (p = 0.02) at a PM concentration of 100 μg. Such a relationship was not observed in the control group. The correlation coefficient between the distance of residence from major roads and urinary 1-OHP was 0.62. A Pearson correlation analysis of quantitative variables was performed, and positive correlation results were obtained in the atopy group between BP and 1-OH-P. Exposure to birch pollen and PM2.5 has a synergistic effect in sensitized individuals. The higher the exposure to pollutants, the higher the synergistic basophil response to the allergen and PM in atopic patients.

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