The case for impulse oscillometry in the management of asthma in children and adults

Stanley P. Galant (Lead / Corresponding author), Hirsh D. Komarow, Hye-Won Shin, Salman Siddiqui, Brian J. Lipworth

Research output: Contribution to journalReview article

28 Citations (Scopus)
236 Downloads (Pure)

Abstract

Objective: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment.

Data Sources: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma.

Study Selections: Articles included in this review were based on the expert opinion and previous publications by the authors.

Results: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations. IOS predicts young children at risk for loss of lung function with age and the potential for early intervention to prevent further sequelae. In adults, peripheral airway impairment detected by IOS or spirometry (ie, forced expiratory flow between 25% and 75%) commonly occurs across severity, and each measure may be complementary in predicting loss of control even with normal forced expiratory volume in 1 second. Extrafine inhaled corticosteroids with or without long-acting β-agonists proved superior to standard particle aerosols in improving IOS-detected peripheral airway obstruction. Our data also suggest that currently available commercial reference values for lung resistance at 5 Hz and lung reactance at 5 Hz are applicable across diverse populations, but further studies are needed.

Conclusion: The findings of this review suggest that IOS can add value to traditional clinical and spirometric assessment and thus improve management of asthma in children and adults, as well as have the potential to detect early dysfunction of the peripheral airways, which may result in better outcomes.

Original languageEnglish
Pages (from-to)664-671
Number of pages8
JournalAnnals of Allergy, Asthma & Immunology
Volume118
Issue number6
Early online date2 Jun 2017
DOIs
Publication statusPublished - Jun 2017

Fingerprint

Oscillometry
Asthma
Spirometry
Lung
Information Storage and Retrieval
Forced Expiratory Volume
Expert Testimony
Airway Obstruction
Aerosols
PubMed
Adrenal Cortex Hormones
Reference Values
Language

Keywords

  • Impulse oscillometry
  • Peripheral airway impairment
  • Spirometry
  • Bronchodilator Response
  • Extrafine Aerosols
  • Asthma
  • Reference values
  • Clinical Outcomes

Cite this

Galant, Stanley P. ; Komarow, Hirsh D. ; Shin, Hye-Won ; Siddiqui, Salman ; Lipworth, Brian J. / The case for impulse oscillometry in the management of asthma in children and adults. In: Annals of Allergy, Asthma & Immunology. 2017 ; Vol. 118, No. 6. pp. 664-671.
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note = "This work was partially supported by grant P01HD048721 from the National Institutes of Health Program Project (Dr Shin), and the Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (Dr Komarow). Dr. Lipworth reports grants and personal fees from Chiesi, grants and personal fees from Teva, Personal fees from MEDA, during the conduct of the study; personal fees from Dr. Reddys, personal fees from Sandoz, personal fees from Cipla, personal fees from Boerhinger, outside the submitted work.",
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The case for impulse oscillometry in the management of asthma in children and adults. / Galant, Stanley P. (Lead / Corresponding author); Komarow, Hirsh D.; Shin, Hye-Won; Siddiqui, Salman; Lipworth, Brian J.

In: Annals of Allergy, Asthma & Immunology, Vol. 118, No. 6, 06.2017, p. 664-671.

Research output: Contribution to journalReview article

TY - JOUR

T1 - The case for impulse oscillometry in the management of asthma in children and adults

AU - Galant, Stanley P.

AU - Komarow, Hirsh D.

AU - Shin, Hye-Won

AU - Siddiqui, Salman

AU - Lipworth, Brian J.

N1 - This work was partially supported by grant P01HD048721 from the National Institutes of Health Program Project (Dr Shin), and the Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (Dr Komarow). Dr. Lipworth reports grants and personal fees from Chiesi, grants and personal fees from Teva, Personal fees from MEDA, during the conduct of the study; personal fees from Dr. Reddys, personal fees from Sandoz, personal fees from Cipla, personal fees from Boerhinger, outside the submitted work.

PY - 2017/6

Y1 - 2017/6

N2 - Objective: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment.Data Sources: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma.Study Selections: Articles included in this review were based on the expert opinion and previous publications by the authors.Results: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations. IOS predicts young children at risk for loss of lung function with age and the potential for early intervention to prevent further sequelae. In adults, peripheral airway impairment detected by IOS or spirometry (ie, forced expiratory flow between 25% and 75%) commonly occurs across severity, and each measure may be complementary in predicting loss of control even with normal forced expiratory volume in 1 second. Extrafine inhaled corticosteroids with or without long-acting β-agonists proved superior to standard particle aerosols in improving IOS-detected peripheral airway obstruction. Our data also suggest that currently available commercial reference values for lung resistance at 5 Hz and lung reactance at 5 Hz are applicable across diverse populations, but further studies are needed.Conclusion: The findings of this review suggest that IOS can add value to traditional clinical and spirometric assessment and thus improve management of asthma in children and adults, as well as have the potential to detect early dysfunction of the peripheral airways, which may result in better outcomes.

AB - Objective: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment.Data Sources: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma.Study Selections: Articles included in this review were based on the expert opinion and previous publications by the authors.Results: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations. IOS predicts young children at risk for loss of lung function with age and the potential for early intervention to prevent further sequelae. In adults, peripheral airway impairment detected by IOS or spirometry (ie, forced expiratory flow between 25% and 75%) commonly occurs across severity, and each measure may be complementary in predicting loss of control even with normal forced expiratory volume in 1 second. Extrafine inhaled corticosteroids with or without long-acting β-agonists proved superior to standard particle aerosols in improving IOS-detected peripheral airway obstruction. Our data also suggest that currently available commercial reference values for lung resistance at 5 Hz and lung reactance at 5 Hz are applicable across diverse populations, but further studies are needed.Conclusion: The findings of this review suggest that IOS can add value to traditional clinical and spirometric assessment and thus improve management of asthma in children and adults, as well as have the potential to detect early dysfunction of the peripheral airways, which may result in better outcomes.

KW - Impulse oscillometry

KW - Peripheral airway impairment

KW - Spirometry

KW - Bronchodilator Response

KW - Extrafine Aerosols

KW - Asthma

KW - Reference values

KW - Clinical Outcomes

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DO - 10.1016/j.anai.2017.04.009

M3 - Review article

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VL - 118

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JO - Annals of Allergy, Asthma & Immunology

JF - Annals of Allergy, Asthma & Immunology

SN - 1081-1206

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