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      International Journal of COPD (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on pathophysiological processes underlying Chronic Obstructive Pulmonary Disease (COPD) interventions, patient focused education, and self-management protocols. Sign up for email alerts here.

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      Is Open Access

      Evaluation of Exertional Ventilatory Parameters Using Oscillometry in COPD

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          Abstract

          Background

          Oscillometry is a tool to measure respiratory impedance that requires minimal patients’ effort. In patients with chronic obstructive pulmonary disease (COPD), the correlation of respiratory impedance at rest with exertional ventilatory parameters, including exercise tolerance, has scarcely been reported. In addition, the utility of oscillometric parameters might differ between the inspiratory and expiratory phases due to airflow obstruction during expiration, but the hypothesis had not been validated. The aim of the present study was to investigate whether oscillometric parameters are associated with exertional ventilatory parameters in patients with COPD.

          Methods

          Fifty-five subjects with COPD who attended clinics at the National Hospital Organization Osaka Toneyama Medical Center performed spirometry, oscillometry, and cardiopulmonary exercise testing (CPET) within 2 weeks. The correlations between parameters of spirometry, oscillometry, and CPET were analyzed using Spearman’s rank correlation coefficient, univariate, and multivariate analyses.

          Results

          Respiratory reactance had better correlations with the CPET parameters than respiratory resistance. Moreover, inspiratory reactance at rest correlated with the CPET parameters stronger than expiratory reactance. In particular, inspiratory resonant frequency (Fres-ins) correlated with peak oxygen uptake (r S=−0.549, p<0.01) and dead space to tidal volume ratio at peak exercise (r S=0.677, p<0.01) and the best predicted expiratory tidal volume (V T ex) at peak exercise of all the oscillometric parameters (r S=−0.679, p<0.01). However, the correlation between Fres-ins and V T ex at peak exercise became weak in subjects with severe and very severe COPD during exercise.

          Conclusion

          Measurement of respiratory reactance is useful for the effortless evaluation of not only exertional ventilatory parameters but exercise tolerance in patients with COPD. The correlation of respiratory impedance with exertional ventilatory parameters can become weak in patients with advanced COPD; thus, the measurement of oscillometry might not be appropriate for evaluating exertional ventilatory parameters of patients with advanced COPD.

          Most cited references24

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          The forced oscillation technique in clinical practice: methodology, recommendations and future developments

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            Reference values for spirometry, including vital capacity, in Japanese adults calculated with the LMS method and compared with previous values.

            Reference values for lung function tests should be periodically updated because of birth cohort effects and improved technology. This study updates the spirometric reference values, including vital capacity (VC), for Japanese adults and compares the new reference values with previous Japanese reference values.
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              Impulse oscillometry: interpretation and practical applications.

              Simple spirometry and body plethysmography have been routinely used in children aged > 5 years. New techniques based on physiologic concepts that were first described almost 50 years ago are emerging in research and in clinical practice for measuring pulmonary function in children. These techniques have led to an increased understanding of the pediatric lung and respiratory mechanics. Impulse oscillometry (IOS), a simple, noninvasive method using the forced oscillation technique, requires minimal patient cooperation and is suitable for use in both children and adults. This method can be used to assess obstruction in the large and small peripheral airways and has been used to measure bronchodilator response and bronchoprovocation testing. New data suggest that IOS may be useful in predicting loss of asthma control in the pediatric population. This article reviews the clinical applications of IOS, with an emphasis on the pediatric setting, and discusses appropriate coding practices for the clinician.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                COPD
                copd
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove
                1176-9106
                1178-2005
                13 July 2020
                2020
                : 15
                : 1697-1711
                Affiliations
                [1 ]Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center , Osaka, Japan
                Author notes
                Correspondence: Keisuke Miki Department of Respiratory Medicine, National Hospital Organization Osaka Toneyama Medical Center , 5-1-1 Toneyama, Toyonaka, Osaka560-8552, JapanTel +81-6-6853-2001Fax +81-6-6853-3127 Email miki.keisuke.pu@mail.hosp.go.jp
                Author information
                http://orcid.org/0000-0002-5489-5079
                http://orcid.org/0000-0002-3600-8595
                http://orcid.org/0000-0001-7761-9256
                Article
                260735
                10.2147/COPD.S260735
                7367741
                32764915
                c61840cc-c48c-4533-b791-ad6b1738506f
                © 2020 Yamamoto et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 30 April 2020
                : 02 July 2020
                Page count
                Figures: 4, Tables: 7, References: 37, Pages: 15
                Funding
                Funded by: no specific funding for the present study
                The authors received no specific funding for the present study.
                Categories
                Original Research

                Respiratory medicine
                dyspnea,dynamic hyperinflation,airflow obstruction,resonant frequency,tidal volume

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