The utility of the forced oscillation technique in assessing bronchodilator responsiveness in patients with asthma

Autor: Makito Yaegashi, Albert E. Heurich, Michael J. Akerman, Venkata A.K. Yalamanchili, Vaidehi Kaza, Jeremy Weedon
Rok vydání: 2007
Předmět:
Zdroj: Respiratory Medicine. 101(5):995-1000
ISSN: 0954-6111
DOI: 10.1016/j.rmed.2006.09.001
Popis: Summary Objective : To address the utility of the forced oscillation technique (FOT) in assessing bronchodilator responsiveness compared with forced expiratory volume in 1s (FEV 1 ). Methods : This is a retrospective analysis of consecutive 126 patients with a clinical history of asthma without any other lung diseases at a pulmonary function testing laboratory. The following measurements were obtained three times each, before and after two doses of pirbuterol 0.2mg inhalation: the respiratory resistance at 5Hz ( R rs5), the mean respiratory resistance between 5 and 20Hz ( R rs5–20), and the mean respiratory conductance (Grs5–20) by FOT and the FEV 1 by spirometer. These measurements were transformed into dimensionless subject-specific effect-size " d -scores" by dividing them by the estimated pooled within-subject standard deviation. Results : Descriptive statistics for each value were the following [mean baseline value (±sd), Δ value (pre- minus post value), and d -score ( P value compared to FEV 1 )]: Grs5–20 (Ls −1 kPa −1 ) [1.79±0.53, Δ =+0.39, d =2.64 ( P R rs5–20 (kPaL −1 s) [0.60±0.16L, Δ =−0.10, d =2.56 ( P =0.001)], R rs5 (kPaL −1 s) [0.78±0.25, Δ =−0.16, d =2.52 ( P 1 (L) [1.90±0.64, Δ =−0.20, d =1.83]. The higher d -score of Grs5–20, R rs5–20 and R rs5 compared to FEV 1 indicates that these are better indicators for bronchodilator response than FEV 1 . The percentages of subjects exhibiting change in the expected direction after bronchodilator were not significantly different between each value: R rs5 (85.7%), R rs5–20 (83.3%), Grs5–20 (83.3%), and FEV 1 (83.3%) [ P >0.05]. Conclusions : Several forced oscillation measures, namely Grs5–20, R rs5–20 and R rs5, are more accurate and sensitive for detecting bronchodilator response than FEV 1 in patients with asthma.
Databáze: OpenAIRE