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Usefulness of Impulse Oscillometry in Predicting the Severity of Bronchiectasis

  • Ji Soo Choi (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Se Hyun Kwak (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Min Chul Kim (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Chang Hwan Seol (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Seok-Jae Heo (Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine) ;
  • Sung Ryeol Kim (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine) ;
  • Eun Hye Lee (Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine)
  • Received : 2023.10.18
  • Accepted : 2024.04.19
  • Published : 2024.07.31

Abstract

Background: Bronchiectasis is a chronic respiratory disease that leads to airway inflammation, destruction, and airflow limitation, which reflects its severity. Impulse oscillometry (IOS) is a non-invasive method that uses sound waves to estimate lung function and airway resistance. The aim of this study was to assess the usefulness of IOS in predicting the severity of bronchiectasis. Methods: We retrospectively reviewed the IOS parameters and clinical characteristics in 145 patients diagnosed with bronchiectasis between March 2020 and May 2021. Disease severity was evaluated using the FACED score, and patients were divided into mild and moderate/severe groups. Results: Forty-four patients (30.3%) were in the moderate/severe group, and 101 (69.7%) were in the mild group. Patients with moderate/severe bronchiectasis had a higher airway resistance at 5 Hz (R5), a higher difference between the resistance at 5 and 20 Hz (R5-R20), a higher resonant frequency (Fres), and a higher area of reactance (AX) than patients with mild bronchiectasis. R5 ≥0.43, resistance at 20 Hz (R20) ≥0.234, R5-R20 ≥28.3, AX ≥1.02, reactance at 5 Hz (X5) ≤-0.238, and Fres ≥20.88 revealed significant univariable relationships with bronchiectasis severity (p<0.05). Among these, only X5 ≤-0.238 exhibited a significant multivariable relationship with bronchiectasis severity (p=0.039). The receiver operating characteristic curve for predicting moderate-to-severe bronchiectasis of FACED score based on IOS parameters exhibited an area under the curve of 0.809. Conclusion: The IOS assessed by the disease severity of FACED score can effectively reflect airway resistance and elasticity in bronchiectasis patients and serve as valuable tools for predicting bronchiectasis severity.

Keywords

References

  1. Chalmers JD, Chang AB, Chotirmall SH, Dhar R, McShane PJ. Bronchiectasis. Nat Rev Dis Primers 2018;4:45. 
  2. Quint JK, Millett ER, Joshi M, Navaratnam V, Thomas SL, Hurst JR, et al. Changes in the incidence, prevalence and mortality of bronchiectasis in the UK from 2004 to 2013: a population-based cohort study. Eur Respir J 2016;47:186-93. 
  3. Weycker D, Hansen GL, Seifer FD. Prevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013. Chron Respir Dis 2017;14:377-84. 
  4. Choi H, Yang B, Nam H, Kyoung DS, Sim YS, Park HY, et al. Population-based prevalence of bronchiectasis and associated comorbidities in South Korea. Eur Respir J 2019;54:1900194. 
  5. Chalmers JD, Aliberti S, Filonenko A, Shteinberg M, Goeminne PC, Hill AT, et al. Characterization of the "frequent exacerbator phenotype" in bronchiectasis. Am J Respir Crit Care Med 2018;197:1410-20. 
  6. Chalmers JD, Goeminne P, Aliberti S, McDonnell MJ, Lonni S, Davidson J, et al. The bronchiectasis severity index: an international derivation and validation study. Am J Respir Crit Care Med 2014;189:576-85. 
  7. Martinez-Garcia MA, de Gracia J, Vendrell Relat M, Giron RM, Maiz Carro L, de la Rosa Carrillo D, et al. Multidimensional approach to non-cystic fibrosis bronchiectasis: the FACED score. Eur Respir J 2014;43:1357-67. 
  8. Bickel S, Popler J, Lesnick B, Eid N. Impulse oscillometry: interpretation and practical applications. Chest 2014;146:841-7. 
  9. Kim SR, Park KH, Son NH, Moon J, Park HJ, Kim K, et al. Application of impulse oscillometry in adult asthmatic patients with preserved lung function. Allergy Asthma Immunol Res 2020;12:832-43. 
  10. Sugiyama A, Hattori N, Haruta Y, Nakamura I, Nakagawa M, Miyamoto S, et al. Characteristics of inspiratory and expiratory reactance in interstitial lung disease. Respir Med 2013;107:875-82. 
  11. Abdeyrim A, Li N, Shao L, Heizhati M, Wang Y, Yao X, et al. What can impulse oscillometry and pulmonary function testing tell us about obstructive sleep apnea: a case-control observational study? Sleep Breath 2016;20:61-8. 
  12. Bednarek M, Grabicki M, Piorunek T, Batura-Gabryel H. "Current place of impulse oscillometry in the assessment of pulmonary diseases". Respir Med 2020;170:105952. 
  13. Martinez-Garcia MA, Polverino E, Aksamit T. Bronchiectasis and chronic airway disease: it is not just about asthma and COPD. Chest 2018;154:737-9. 
  14. King PT. The pathophysiology of bronchiectasis. Int J Chron Obstruct Pulmon Dis 2009;4:411-9. 
  15. Brashier B, Salvi S. Measuring lung function using sound waves: role of the forced oscillation technique and impulse oscillometry system. Breathe (Sheff) 2015;11:57-65. 
  16. Kaminsky DA, Simpson SJ, Berger KI, Calverley P, de Melo PL, Dandurand R, et al. Clinical significance and applications of oscillometry. Eur Respir Rev 2022;31:210208. 
  17. Song TW, Kim KW, Kim ES, Park JW, Sohn MH, Kim KE. Utility of impulse oscillometry in young children with asthma. Pediatr Allergy Immunol 2008;19:763-8. 
  18. Oostveen E, Dom S, Desager K, Hagendorens M, De Backer W, Weyler J. Lung function and bronchodilator response in 4-year-old children with different wheezing phenotypes. Eur Respir J 2010;35:865-72. 
  19. Marotta A, Klinnert MD, Price MR, Larsen GL, Liu AH. Impulse oscillometry provides an effective measure of lung dysfunction in 4-year-old children at risk for persistent asthma. J Allergy Clin Immunol 2003;112:317-22. 
  20. King GG, Bates J, Berger KI, Calverley P, de Melo PL, Dellaca RL, et al. Technical standards for respiratory oscillometry. Eur Respir J 2020;55:1900753. 
  21. Batmaz SB, Kuyucu S, Arikoglu T, Tezol O, Aydogdu A. Impulse oscillometry in acute and stable asthmatic children: a comparison with spirometry. J Asthma 2016;53:179-86. 
  22. Fujii M, Shirai T, Mori K, Mikamo M, Shishido Y, Akita T, et al. Inspiratory resonant frequency of forced oscillation technique as a predictor of the composite physiologic index in interstitial lung disease. Respir Physiol Neurobiol 2015;207:22-7. 
  23. Porojan-Suppini N, Fira-Mladinescu O, Marc M, Tudorache E, Oancea C. Lung function assessment by impulse oscillometry in adults. Ther Clin Risk Manag 2020;16:1139-50. 
  24. Yamamoto Y, Miki K, Tsujino K, Kuge T, Matsuki T, Fukushima K, et al. Evaluation of disease severity in bronchiectasis using impulse oscillometry. ERJ Open Res 2020;6:00053-2020. 
  25. Tan C, Ma D, Wang K, Tu C, Chen M, Zheng X, et al. The role of impulse oscillometry in evaluating disease severity and predicting the airway reversibility in patients with bronchiectasis. Front Med (Lausanne) 2022;9:796809. 
  26. Schulz H, Flexeder C, Behr J, Heier M, Holle R, Huber RM, et al. Reference values of impulse oscillometric lung function indices in adults of advanced age. PLoS One 2013;8:e63366.