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Measuring lung function using sound waves: role of the forced oscillation technique and impulse oscillometry system

Bill Brashier, Sundeep Salvi
Breathe 2015 11: 57-65; DOI: 10.1183/20734735.020514
Bill Brashier
Chest Research Foundation, Marigold Complex, Kalyaninagar, Pune, India
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Sundeep Salvi
Chest Research Foundation, Marigold Complex, Kalyaninagar, Pune, India
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  • For correspondence: ssalvi@crfindia.com
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  • Figure 1
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    Figure 1

    Type of sound waves in FOT and IOS and distances travelled by sound waves of different frequencies.

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    Figure 2

    Respiratory resistance versus frequency.

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    Figure 3

    Reactance values in a healthy subject showing the “C” (compliance) and “I” (inertance) portions of reactance, area of reactance (AX) and resonant frequency (Fres).

  • Figure 4
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    Figure 4

    Position of the patient while performing IOS. Note how the cheeks are held firmly.

  • Figure 5
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    Figure 5

    Mean a) ΔAX and b) ΔX5 values in healthy subjects, and patients with asthma, COPD and ILD. Adapted from [28] with permission from the publisher.

Tables

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  • Table 1

    Differences between spirometry and FOT/IOS

    ParameterSpirometryFOT/IOS
    Main principleFlow sensor/volume displacement helps measure flow rates and lung volumesForced oscillations of single frequency sound waves (FOT) or impulses of multiple frequency sound waves (IOS) are pushed into the lungs as pressure waves to measure respiratory resistance and reactance
    Main parametersVolumes: FEV1, FVCZrs, Rrs, Xrs, Fres, Ax
    Flows: PEFR, FEF25–75%
    Patient co-operation required++++
    Type of breathing manoeuvreForced exhalationTidal breathing
    Variability (intra-subject)3–5%5–15%
    Sensitivity to airway location
    Central++++
    Peripheral+++++
    Cut off for bronchodilator response12–15% for FEV140% for R5 or X5
    Cut off for bronchoconstrictor response20% for FEV150% for R5
    Insight into lung mechanics++++
    Standardised methodology+++++
    Availability of robust reference values++++
    • FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; PEFR: peak expiratory flow rate; FEF25–75%: forced expiratory flow at 25–75% of FVC; Zrs: respiratory impedance; Rrs: respiratory resistance; Xrs: respiratory reactance; Fres: resonant frequency; Ax: reactance area; R5: respiratory resistance at 5 Hz; X5: respiratory reactance at 5 Hz.

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Breathe: 11 (1)
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Measuring lung function using sound waves: role of the forced oscillation technique and impulse oscillometry system
Bill Brashier, Sundeep Salvi
Breathe Mar 2015, 11 (1) 57-65; DOI: 10.1183/20734735.020514

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Measuring lung function using sound waves: role of the forced oscillation technique and impulse oscillometry system
Bill Brashier, Sundeep Salvi
Breathe Mar 2015, 11 (1) 57-65; DOI: 10.1183/20734735.020514
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