Advantage of impulse oscillometry over spirometry to diagnose chronic obstructive pulmonary disease and monitor pulmonary responses to bronchodilators: An observational study

Constantine Saadeh, Charles Saadeh, Blake Cross, Michael Gaylor, Melissa Griffith, Constantine Saadeh, Charles Saadeh, Blake Cross, Michael Gaylor, Melissa Griffith

Abstract

Objectives: This retrospective study was a comparative analysis of sensitivity of impulse oscillometry and spirometry techniques for use in a mixed chronic obstructive pulmonary disease group for assessing disease severity and inhalation therapy.

Methods: A total of 30 patients with mild-to-moderate chronic obstructive pulmonary disease were monitored by impulse oscillometry, followed by spirometry. Lung function was measured at baseline after bronchodilation and at follow-up (3-18 months). The impulse oscillometry parameters were resistance in the small and large airways at 5 Hz (R5), resistance in the large airways at 15 Hz (R15), and lung reactance (area under the curve X; AX).

Results: After the bronchodilator therapy, forced expiratory volume in 1 second (FEV1) readings evaluated by spirometry were unaffected at baseline and at follow-up, while impulse oscillometry detected an immediate improvement in lung function, in terms of AX (p = 0.043). All impulse oscillometry parameters significantly improved at follow-up, with a decrease in AX by 37% (p = 0.0008), R5 by 20% (p = 0.0011), and R15 by 12% (p = 0.0097).

Discussion: Impulse oscillometry parameters demonstrated greater sensitivity compared with spirometry for monitoring reversibility of airway obstruction and the effect of maintenance therapy. Impulse oscillometry may facilitate early treatment dose optimization and personalized medicine for chronic obstructive pulmonary disease patients.

Keywords: Bronchodilator; chronic obstructive pulmonary disease; impulse oscillometry; spirometry.

Conflict of interest statement

Declaration of conflicting interests: All authors have no conflicts to declare.

Figures

Figure 1.
Figure 1.
Image of the impulse oscillometry apparatus. Both individuals in the photograph provided signed consent to be photographed for the purpose of publication.
Figure 2.
Figure 2.
Impulse oscillation area of reactance (AX) detects bronchodilator efficacy in COPD patients after a single dose. Traces showing AX (a) before and (b) after the first dose of inhalation therapy. Airway resistance was measured over a range of intermittent frequency impulses (5–35 Hz) delivered by a loudspeaker. Thereafter, AX was calculated from the area under the x-axis. Large airway resistance was recorded at frequencies of ⩾15 Hz.

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