성인 천식환자의 기도 가역성 평가 시 Impulse Oscillometry의 유용성

박세은 ( Se Eun Park ),이용원 ( Yong Won Lee ),김성애 ( Sung Ai Kim ),최상태 ( Sang Tae Choi ),한승진 ( Seung Jin Han ),문재훈 ( Jae Hoon Moon ),박수영 ( Soo Young Park ),김범경 ( Beom Kyung Kim ),홍천수 ( Chein Soo Hong ),박중원 대한천식알레르기학회 2005 천식 및 알레르기 Vol.25 No.2

Oscillometry-Defined Small Airway Dysfunction in Patients with Chronic Obstructive Pulmonary Disease

Sajal De,Amit K. Rath,Dibakar Sahu 대한결핵및호흡기학회 2024 Tuberculosis and Respiratory Diseases Vol.87 No.2

Background: The prevalence of small airway dysfunction (SAD) in patients with chronicobstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratoryimpedance. The severity of COPD and lung function abnormalities was graded in accordancewith the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz >upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. Themean forced expiratory volume 1 second (FEV1) % predicted was 56.4%. The medianCOPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD acrossthe GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BDSAD and expiratory flow limitation at tidal breath (EFLT) were present in 62.8% (95%confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function(FEV1% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volumeto total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walkdistance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increaseswith disease severity. SAD is associated with poor lung function and highersymptom burden. Severe SAD is indicated by the presence of EFLT.

Pulmonary Functions and Inflammatory Biomarkers in Post-Pulmonary Tuberculosis Sequelae

Bade Geetanjali,Talwar Anjana,Madan Karan,Kumar Shanmugasundaram 대한결핵및호흡기학회 2022 Tuberculosis and Respiratory Diseases Vol.85 No.2

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls.Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated.Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV1 were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z5), total airway resistance (R5), central airway resistance (R20), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X5, X20) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups.Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

Pulmonary Functions and Inflammatory Biomarkers in Post-Pulmonary Tuberculosis Sequelae

( Kumar Shanmugasundaram ),( Anjana Talwar ),( Karan Madan ),( Geetanjali Bade ) 대한결핵 및 호흡기학회 2022 Tuberculosis and Respiratory Diseases Vol.85 No.2

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls. Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated. Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), FEV₁/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV₁ were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z₅), total airway resistance (R₅), central airway resistance (R₂₀), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X₅, X₂₀) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups. Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.

소아의 기도 폐쇄 평가에서 impulse oscillometry system과 폐활량 측정법의 비교

허혜영,곽지희,김형윤,정다운,신윤호,한만용 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.8

Purpose:Measurement of forced expiratory volume in 1 second (FEV1) is usually difficult to obtain in children under six years of age because it requires active cooperation. This study evaluates the sensitivity of impulse oscillometry system (IOS) parameters for detecting airway obstruction in comparison with FEV1. Methods:We studied 174 children who performed the lung function and methacholine challenge tests to diagnose asthma by IOS and spirometry. Children were divided into two subgroups according to their PC20, which is a parameter for bronchial sensitivity. We compared IOS parameters with FEV1 at the baseline, post-methacholine challenge, and evaluated their correlation. Results:At the baseline, reactance at 5 Hz (X5) and resistance at 5 Hz (R5) significantly differed between the PC20 positive (PC20≤16 mg/mL) group and PC20 negative (PC20 >16 mg/mL) group; however, FEV1, FEV1 % predicted, FEV1_Zs (Z score) did not differ. FEV1 is correlated with X5 (r=0.45, P<0.01) and R5 (r=―0.69, P<0.01). FEV1_Zs is also correlated with X5_Zs (r=―0.26, P<0.01) and R5_Zs (r=―0.31, P<0.01). After the methacholine challenge test, dose-response slopes in FEV1 and X5 significantly differed between the two subgroups (P<0.05). Conclusion:IOS parameters were more discriminative than FEV1 for detecting decreased baseline lung function between two subgroups and have a good correlation with FEV1. (Korean J Pediatr 2008;51:842-847) Purpose:Measurement of forced expiratory volume in 1 second (FEV1) is usually difficult to obtain in children under six years of age because it requires active cooperation. This study evaluates the sensitivity of impulse oscillometry system (IOS) parameters for detecting airway obstruction in comparison with FEV1. Methods:We studied 174 children who performed the lung function and methacholine challenge tests to diagnose asthma by IOS and spirometry. Children were divided into two subgroups according to their PC20, which is a parameter for bronchial sensitivity. We compared IOS parameters with FEV1 at the baseline, post-methacholine challenge, and evaluated their correlation. Results:At the baseline, reactance at 5 Hz (X5) and resistance at 5 Hz (R5) significantly differed between the PC20 positive (PC20≤16 mg/mL) group and PC20 negative (PC20 >16 mg/mL) group; however, FEV1, FEV1 % predicted, FEV1_Zs (Z score) did not differ. FEV1 is correlated with X5 (r=0.45, P<0.01) and R5 (r=―0.69, P<0.01). FEV1_Zs is also correlated with X5_Zs (r=―0.26, P<0.01) and R5_Zs (r=―0.31, P<0.01). After the methacholine challenge test, dose-response slopes in FEV1 and X5 significantly differed between the two subgroups (P<0.05). Conclusion:IOS parameters were more discriminative than FEV1 for detecting decreased baseline lung function between two subgroups and have a good correlation with FEV1. (Korean J Pediatr 2008;51:842-847)

The Usefulness of Impulse Oscillometry for Estimating the Severity of Bronchiectasis

( Ji Soo Choi ),( Se Hyun Kwak ),( Min Chul Kim ),( Chang Hwan Seol ),( Sung Ryeol Kim ),( Byung Hoon Park ),( Eun Hye Lee ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Purpose Bronchiectasis is a chronic respiratory disease that causes airway inflammation and destruction, and airflow limitation reflects the disease severity in bronchiectasis. Impulse oscillometry (IOS) is a noninvasive method to estimate lung function using sound waves. The aim of this study was to identify the usefulness of IOS for predicting the disease severity in bronchiectasis. Method We retrospectively reviewed the IOS parameters, clinical characteristics, and Results of other examinations in 132 patients with bronchiectasis between March 2020 and April 2021. The severity of disease was assessed through FACED score. The patients were divided into two groups, a mild group and a moderate/severe group based on the FACED score three points. Result Ninety-four patients (71.2%) were in the mild group and 38 patients (28.9%) were in the moderate/severe group. The mean predicted forced expiratory volume in 1 second (FEV1) was 77.3% in the mild group and 53.5% in the moderate/severe group. Patients with moderate/severe severity of bronchiectasis had higher airway resistance at 5 Hz (R5) (p < 0.001), difference between the resistance at 5 and 20 Hz (26.2 vs 43.5, R5 - R20) (p < 0.001), resonant frequency (fres) (p < 0.001), and reactance area (AX) (0.68 vs 2.46, p < 0.001) than patients with mild severity. There was no difference in the airway resistance at 20 Hz (R20) between group. Conclusion IOS parameter could reflect airway resistance in patients with bronchiectasis, especially in peripheral airway resistance, and associated with the disease severity of bronchiectasis.

기관지 천식에서 impulse oscillometry(IOS)의 유용성

김중선(Jung Sun Kim),김철우(Cheol Woo Kim),박정엽(Jeong Youp Park),정혜원(Hye Won Chung),박중원(Jung Won Park),홍천수(Chein Soo Hong) 대한내과학회 2000 대한내과학회지 Vol.59 No.5

Background : Impulse oscillometry(IOS) is a method to characterize the mechanical properties of respiratory system over wide range of frequency. It's most important advantage is to require minimal cooperations from subject. Therefore it is used to estimate pulmonary function of young children and to study epidemiology of occupational asthma. This study was performed to evaluate the usefulness for the clinical applications of IOS in bronchial asthmatics by estimating the associations between asthma severity and IOS parameters, and the relationships between IOS parameters and conventional spirometry. Methods : 216 subjects with bronchial asthma were enrolled in this study. Subjects were grouped to 3 different groups according to their symptoms and pulmonary functions. Respiratory impedance, resistance (at 5Hz, 20Hz, 35Hz) and resonant frequency were measured by IOS. FEV1, FVC and MMEF were measured with conventional spirometry. Results : There were significant difference of resonant frequency, resistance at 5Hz and 20Hz, resistance difference at 5Hz and 20Hz according to asthma severity(p<0.05, respectively). Resonant frequency, resistance at 5Hz, impedance were significantly correlated with FEV1 (r= -0.55, 0.48, 0.49, p<0.05, respectively). And resistance at 5Hz had similar reproducibility compared to FEV1 (resistance at 5Hz, r= 0.78 vs FEV1, r= 0.79). Conclusion : IOS is an useful and alternative method to evaluate clinical status of brnochial asthmatics. And further studies will be needed to clarify its values for wide range of clinical applications.(Korean J Med 59:522-528, 2000)

Usefulness of Impulse Oscillometry in Predicting the Severity of Bronchiectasis

( Ji Soo Choi ),( Se Hyun Kwak ),( Min Chul Kim ),( Chang Hwan Seol ),( Seok-jae Heo ),( Sung Ryeol Kim ),( Eun Hye Lee ) 대한결핵 및 호흡기학회 2024 Tuberculosis and Respiratory Diseases Vol.87 No.3

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.

Comparison of bronchial responsiveness assessing dose-response slope between cough-variant asthma and classic asthma in young children

( Jung Won Yoon ),( Hye Young Hur ),( Hye Mi Jee ),( Ji Hyeon Baek ),( Hyeong Yoon Kim ),( Youn Ho Shin ),( Man Yong Han ) 대한천식알레르기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.4

Purpose: Little data is currently available on the use of the impulse oscillometry system (IOS) parameter in analyzing the lung func-tion of young children with cough-variant asthma (CVA) and classic asthma. The aims of this study were to evaluate the bronchial responsiveness between patients with CVA and those with classic asthma using dose-response slope and various cutoff values. Methods: A methacholine challenge test and a pulmonary function test were performed in 43 children with classic asthma and 26 children with CVA using IOS, and the respiratory resistance (Rrs) and reactance (Xrs) were obtained. The bronchial responsiveness were assessed by provocative concentration causing an 80% fall from baseline in reactance at 5 Hz (PC80_Xrs5) and a 40% increase in resistance at 5 Hz (PC40_Rrs5) and calculating from the degree of dose-response slope (DRS) for airway resistance and reactance.Results: There was no significant difference in base lung function between the two groups. However, the mean DRS_Xrs5 and the number who showed more than an 80% fall in reactance were significantly higher in classic asthma group than those in CVA group (P=0.040 and P=0.040, respectively).Conclusion: The use of DRS in oscillatory reactance at 5 Hz is useful for the differential diagnosis of classic asthma and CVA based on bronchial hyperresponsiveness.

ORIGINAL ARTICLE : Comparison of bronchial responsiveness assessing dose-response slope between cough-variant asthma and classic asthma in young children

( Jung Won Yoon ),( Hye Young Hur ),( Hye Mi Jee ),( Ji Hyeon Baek ),( Hyeong Yoon Kim ),( Youn Ho Shin ),( Man Yong Han ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1991 소아알레르기 및 호흡기학회지 Vol.1 No.4

Purpose: Little data is currently available on the use of the impulse oscillometry system (IOS) parameter in analyzing the lung func-tion of young children with cough-variant asthma (CVA) and classic asthma. The aims of this study were to evaluate the bronchial responsiveness between patients with CVA and those with classic asthma using dose-response slope and various cutoff values. Methods: A methacholine challenge test and a pulmonary function test were performed in 43 children with classic asthma and 26 children with CVA using IOS, and the respiratory resistance (Rrs) and reactance (Xrs) were obtained. The bronchial responsiveness were assessed by provocative concentration causing an 80% fall from baseline in reactance at 5 Hz (PC80_Xrs5) and a 40% increase in resistance at 5 Hz (PC40_Rrs5) and calculating from the degree of dose-response slope (DRS) for airway resistance and reactance. Results: There was no significant difference in base lung function between the two groups. However, the mean DRS_Xrs5 and the number who showed more than an 80% fall in reactance were significantly higher in classic asthma group than those in CVA group (P=0.040 and P=0.040, respectively).Conclusion: The use of DRS in oscillatory reactance at 5 Hz is useful for the differential diagnosis of classic asthma and CVA based on bronchial hyperresponsiveness. (Allergy Asthma Respir Dis 2013;1:309-313)