Evaluating the forced oscillation technique in the detection of early smoking-induced respiratory changes

Alvaro C D Faria, Agnaldo J Lopes, José M Jansen, Pedro L Melo, Alvaro C D Faria, Agnaldo J Lopes, José M Jansen, Pedro L Melo

Abstract

Background: Early detection of the effects of smoking is of the utmost importance in the prevention of chronic obstructive pulmonary disease (COPD). The forced oscillation technique (FOT) is easy to perform since it requires only tidal breathing and offers a detailed approach to investigate the mechanical properties of the respiratory system. The FOT was recently suggested as an attractive alternative for diagnosing initial obstruction in COPD, which may be helpful in detecting COPD in its initial phases. Thus, the purpose of this study was twofold: (1) to evaluate the ability of FOT to detect early smoking-induced respiratory alterations; and (2) to compare the sensitivity of FOT with spirometry in a sample of low tobacco-dose subjects.

Methods: Results from a group of 28 smokers with a tobacco consumption of 11.2 +/- 7.3 pack-years were compared with a control group formed by 28 healthy subjects using receiver operating characteristic (ROC) curves and a questionnaire as a gold standard. The early adverse effects of smoking were adequately detected by the absolute value of the respiratory impedance (Z4Hz), the intercept resistance (R0), and the respiratory system dynamic compliance (Crs, dyn). Z4Hz was the most accurate parameter (Se = 75%, Sp = 75%), followed by R0 and Crs, dyn. The performances of the FOT parameters in the detection of the early effects of smoking were higher than that of spirometry (p < 0.05).

Conclusion: This study shows that FOT can be used to detect early smoking-induced respiratory changes while these pathologic changes are still potentially reversible. These findings support the use of FOT as a versatile clinical diagnostic tool in aiding COPD prevention and treatment.

Figures

Figure 1
Figure 1
Picture describing the forced oscillation measurements in a subject.
Figure 2
Figure 2
Comparisons of the mean values of respiratory system resistance (A) and reactance (B) as a function of frequency in control and smoking subjects.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curves for resistive (A) and reactive (B) FOT indexes. Derived parameters are described in Table 3.

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