Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Pulmonology Reports
Published in: Current Pulmonology Reports 4/2018

01-12-2018 | COPD and Asthma (W Calhoun, Section Editor)

The Use and Interpretation of Impedance Oscillometry in Pulmonary Disorders

Authors: Mohammed F. Zaidan, Shahanaz Meah, Alexander Duarte

Published in: Current Pulmonology Reports | Issue 4/2018

Login to get access

Abstract

Purpose

Chronic respiratory diseases are prevalent among adults and lung function testing is imperative for appropriate diagnosis and treatment. While spirometry is the standard measure of lung function, there exist groups of individuals unable to adequately perform accurate and reproducible lung function testing. Impedance oscillometry system (IOS) is an effort independent test that may be employed to assess airway function in challenging groups such as children and elderly. This review will compare IOS and spirometry and describe the physiologic measurements of lung function and interpretation strategies in adults with chronic airway disease.

Recent Findings

In adults with COPD, impedance oscillometry measurements of airway resistance correlate with the severity of airflow limitation measured with spirometry. In adults with asthma, IOS is a sensitive measure of airway hyperresponsiveness and bronchodilator response.

Summary

Impedance oscillometry is emerging, alternative method to assess lung function in adults.
Literature
1.
Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128.CrossRef
2.
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. Samet J, ed. PLoS Med. 2006;3(11):2011–30.CrossRef
3.
Adeloye D, Chua S, Lee C, Basquill C, Papana A, Theodoratou E, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health. 2015;5(2):020415.CrossRef
4.
National Center for Health Statistics. Health, United States, 2016: with chartbook on long-term trends in health.; 2017.
5.
United States Department of Health and Human Services. The health consequences of smoking—50 years of progress a report of the surgeon general. A Rep Surg Gen. 2014:1081.
6.
Malmberg LP, Pelkonen A, Poussa T, Pohianpalo A, Haahtela T, Turpeinen M. Determinants of respiratory system input impedance and bronchodilator response in healthy Finnish preschool children. Clin Physiol Funct Imaging. 2002;22:64–71.CrossRef
7.
Park JH, Yoon JW, Shin YH, Jee HM, Wee YS, Chang SJ, et al. Reference values for respiratory system impedance using impulse oscillometry in healthy preschool children. Korean J Pediatr. 2011;54(2):64–8.CrossRef
8.
Torre-Bouscoulet L, Velázquez-Uncal M, García-Torrentera R, et al. Spirometry quality in adults with very severe lung function impairment. Respir Care. 2015;60(5):740–3.CrossRef
9.
Schulz H, Flexeder C, Rgen Behr J, et al. Reference values of impulse oscillometric lung function indices in adults of advanced Age. PLoS One. 2013;8(5).CrossRef
10.
Hegewald MJ, Gallo HM, Wilson EL. Accuracy and quality of spirometry in primary care offices. Ann Am Thorac Soc. 2016;13(12):2119–24.CrossRef
11.
Borg BM, Hartley MF, Bailey MJ, Thompson BR. Adherence to acceptability and repeatability criteria for spirometry in complex lung function laboratories. Respir Care. 2012;57(12):2032–8.PubMed
12.
Celli BR, Decramer M, Wedzicha JA, Wilson KC, Agustí A, Criner GJ, et al. An official American Thoracic Society/European Respiratory Society statement: research questions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2015;191(7):e4–e27.CrossRef
13.
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.CrossRef
14.
Dubois AB, Botelho SY, Comroe JH. A new method for measuring airway resistance in man using a body plethysmograph: values in normal subjects and in patients with respiratory disease. J Clin Invest. 1956;35(3):327–35.CrossRef
15.
Smith HJ, Reinhold P GM. Forced oscillation technique and impulse oscillometry. Eur Repir Mon. 2005:72–105.
16.
Uchida A, Ito S, Suki B, Matsubara H, Hasegawa Y. Influence of cheek support on respiratory impedance measured by forced oscillation technique. Springerplus. 2013;2(1):342.CrossRef
17.
Oostveen E, Macleod D, Lorino H, et al. The forced oscillation technique in clinical practice: methodology, recommendations and future developments on behalf of the ERS task force on respiratory impedance measurements. Eur Respir J. 2003;22(6):1026–41.CrossRef
18.
19.
•• Galant SP, Komarow HD, Shin H-W, Siddiqui S, Lipworth BJ. The case for impulse oscillometry in the management of asthma in children and adults. Ann Allergy, Asthma Immunol. 2017;118(6):664–71. Excellent review of the application of IOS in pediatric and adult patients with asthma.CrossRef
20.
Kaminsky DA. What does airway resistance tell us about lung function? Respir Care. 2012;57(1):85–99.CrossRef
21.
• Kalchiem-Dekel Or, Hines SE. Forty years of reference values for respiratory system impedance in adults: 1977-2017. Respir Med. 2018;136:37–47. Summary of published studies reporting normal reference values or prediction equations for impedance oscillometry in adults. Height and gender were major contributors to prediction equations. Elderly subjects were underrepresented and ethnicity may play a role. For adults, reference values and prediction equations for respiratory impedance measurements is limited and there is a need for further large scale collection of respiratory impedance measurements.
22.
Pasker HG, Schepers R, Clément J, Van De Woestijne KP. Total respiratory impedance measured by means of the forced oscillation technique in subjects with and without respiratory complaints. Eur Respir J. 1996;9(1):131–9.CrossRef
23.
Brown NJ, Xuan W, Salome CM, Berend N, Hunter ML, Musk AW(B), et al. Reference equations for respiratory system resistance and reactance in adults. Respir Physiol Neurobiol. 2010;172(3):162–8.CrossRef
24.
Làndsér FJ, Clément J, Van de Woestijne KP. Normal values of total respiratory resistance and reactance determined by forced oscillations. Chest. 1982;81(5):586–91.CrossRef
25.
Clément J, Làndsér FJ, Van de Woestijne KP. Total resistance and reactance in patients with respiratory complaints with and without airways obstruction. Chest. 1983;83(2):215–20.CrossRef
26.
Newbury W, Crockett A, Newbury J. A pilot study to evaluate Australian predictive equations for the impulse oscillometry system. Respirology. 2008;13(7):1070–5.PubMed
27.
Guo YF, Herrmann F, Michel J-P, Janssens J-P. Normal values for respiratory resistance using forced oscillation in subjects >65 years old. Eur Respir J. 2005;26(4):602–8.CrossRef
28.
Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435–52.CrossRef
29.
Vestbo J, Lange P. Can GOLD stage 0 provide information of prognostic value in chronic obstructive pulmonary disease? Am J Respir Crit Care Med. 2002;166(3):329–32.CrossRef
30.
Woodruff PG, Barr RG, Bleecker E, Christenson SA, Couper D, Curtis JL, et al. Clinical significance of symptoms in smokers with preserved pulmonary function. N Engl J Med. 2016;374(19):1811–21.CrossRef
31.
Brown NJ, Xuan W, Salome CM, Berend N, Hunter ML, Musk AW(B), et al. Reference equations for respiratory system resistance and reactance in adults. Respir Physiol Neurobiol. 2010;172(3):162–8.CrossRef
32.
Frantz S, Nihlén U, Dencker M, Engström G, Löfdahl CGG, Wollmer P. Impulse oscillometry may be of value in detecting early manifestations of COPD. Respir Med. 2012;106(8):1116–23.CrossRef
33.
Kolsum U, Borrill Z, Roy K, Starkey C, Vestbo J, Houghton C, et al. Impulse oscillometry in COPD: identification of measurements related to airway obstruction, airway conductance and lung volumes. Respir Med. 2009;103(1):136–43.CrossRef
34.
• Crim C, Celli B, Edwards LD, et al. Respiratory system impedance with impulse oscillometry in healthy and COPD subjects: ECLIPSE baseline results. Respir Med. 2011;105(7):1069–78. Comparison of spirometry and lung impedance measurements by IOS was performed in healthy non-smokers, healthy former smokers, and patients with COPD. In the COPD group, respiratory system impedance was worse compared with controls. Compared to healthy non-smokers, 29–86% of the COPD subjects had values that fell within the 90% confidence interval of several parameters. IOS can be reliably used in large cohorts of subjects to assess respiratory system impedance. CrossRef
35.
Berger KI, Goldring RM, Oppenheimer BW. Should oscillometry be used to screen for airway disease? Yes. Chest. 2015;148(5):1131–5.CrossRef
36.
•• Enright PL. COUNTERPOINT: should oscillometry be used to screen for airway disease? No. Chest. 2015;148(5):1135–6. Balanced discussion regarding the potential benefits and limitations in screening for airway disease.CrossRef
37.
Celli BR, MacNee W, Agusti A, Anzueto A, Berg B, Buist AS, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23(6):932–46.CrossRef
38.
Chung KF, Wenzel SE, Brozek JL, Bush A, Castro M, Sterk PJ, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343–73.CrossRef
39.
Nair A, Ward J, Lipworth BJ. Comparison of bronchodilator response in patients with asthma and healthy subjects using spirometry and oscillometry. Ann Allergy Asthma Immunol. 2011;107(4):317–22.CrossRef
40.
Williamson PA, Clearie K, Menzies D, Vaidyanathan S, Lipworth BJ. Assessment of small-airways disease using alveolar nitric oxide and impulse oscillometry in asthma and COPD. Lung. 2011;189(2):121–9.CrossRef
41.
Robinson PD, King GG, Sears MR, Hong CY, Hancox RJ. Determinants of peripheral airway function in adults with and without asthma. Respirology. 2017;22(6):1110–7.CrossRef
42.
Young HM, Guo F, Eddy RL, Maksym G, Parraga G. Oscillometry and pulmonary MRI measurements of ventilation heterogeneity in obstructive lung disease: relationship to quality of life and disease control. J Appl Physiol. 2018;125(1):73–85.CrossRef
43.
Ortiz G, Menendez R. The effects of inhaled albuterol and salmeterol in 2- to 5-year-old asthmatic children as measured by impulse oscillometry. J Asthma. 2002;39(6):531–6.CrossRef
44.
Komarow HD, Skinner J, Young M, Gaskins D, Nelson C, Gergen PJ, et al. A study of the use of impulse oscillometry in the evaluation of children with asthma: analysis of lung parameters, order effect, and utility compared with spirometry. Pediatr Pulmonol. 2012;47(1):18–26.CrossRef
45.
Mansur AH, Manney S, Ayres JG. Methacholine-induced asthma symptoms correlate with impulse oscillometry but not spirometry. Respir Med. 2008;102(1):42–9.CrossRef
46.
Naji N, Keung E, Kane J, Watson RM, Killian KJ, Gauvreau GM. Comparison of changes in lung function measured by plethymography and IOS after bronchoprovocation. Respir Med. 2013;107(4):503–10.CrossRef
47.
Schulze J, Smith HJ, Fuchs J, Herrmann E, Dressler M, Rose MA, et al. Methacholine challenge in young children as evaluated by spirometry and impulse oscillometry. Respir Med. 2012;106(5):627–34.CrossRef
48.
Short PM, Anderson WJ, Manoharan A, Lipworth BJ. Usefulness of impulse oscillometry for the assessment of airway hyperresponsiveness in mild-to-moderate adult asthma. Ann Allergy Asthma Immunol. 2015;115(1):17–20.CrossRef
Metadata
Title
The Use and Interpretation of Impedance Oscillometry in Pulmonary Disorders
Authors
Mohammed F. Zaidan
Shahanaz Meah
Alexander Duarte
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Pulmonology Reports / Issue 4/2018
Electronic ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-018-0218-z

Other articles of this Issue 4/2018

Current Pulmonology Reports 4/2018 Go to the issue

COPD and Asthma (W Calhoun, Section Editor)

Evidence-Based Assessment of Bronchial Thermoplasty in Asthma: Mechanisms and Outcomes

Interstitial Lung Disease (A. Hajari Case, Section Editor)

Nonpharmacological Therapies for Interstitial Lung Disease

Interstitial Lung Disease (A Hajari Case, Section Editor)

The Diagnostic Approach to Interstitial Lung Disease

Lung Cancer (R Mudad, Section Editor)

The Changing Paradigm of Treatment for Non-Small Cell Lung Cancer Intracranial Metastases

Lung Cancer (R Mudad, Section Editor)

Pneumonitis in Patients with Lung Cancer Following Treatment: the Effects of Chemotherapy, Immunotherapy, and Tyrosine Kinase Inhibitors

Lung Transplant (R Bag, Section Editor)

Lung Transplantation in Connective Tissue Disease-Associated Interstitial Lung Disease (CTD-ILD)
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits