Detection of the Airway Obstruction Stage in Asthma Using Impulse Oscillometry System

Abstract

Objective. Although spirometry is the most common method for evaluating the airway obstruction stage in asthma patients, it is difficult to perform in some patients. The aim of this study was to evaluate whether impulse oscillometry, an easy-to-perform technique, can detect asthmatic airway obstruction stage. Methods. A total of 80 subjects, including healthy volunteers and patients with asthma, were enrolled in this study. The asthma patients were classified into three groups according to American Thoracic Society (ATS)/European Respiratory Society (ERS)-2005: the mild group (forced expiratory volume in 1 second (FEV₁) ≥ 70% predicted (Pred), n = 20), the moderate group (50% Pred ≤ FEV₁ <70% Pred, n = 20), and the severe group (FEV₁ < 50% Pred, n = 20). Spirometry and impulse oscillometry (IOS) parameters were obtained from every subject. Correlation analysis was used to compare spirometry measurements and IOS parameters. One-way analysis of variance (ANOVA) was performed to compare IOS parameters among different groups. The potential of using all individual IOS parameters to detect the different stages of asthmatic airway obstruction was evaluated by the receiver operating characteristic (ROC) curve analysis. Results. The correlation analysis showed that IOS parameters, such as respiratory resistance at 5 Hz (R₅), respiratory resistance at 10 Hz (R₁₀), respiratory resistance at 20 Hz (R₂₀), difference in resistance between 5 Hz and 20 Hz (R_5–20), impedance at 5 Hz (Z₅), resonant frequency (Fres), and area of reactance (AX) were negatively correlated with FEV₁ and peak expiratory flow (PEF), while reactance at 5 Hz (X₅) was positively correlated with FEV₁ and PEF. The increase in R₅, R₁₀, R₂₀, Z₅, R_5–20, Fres, (−X₅), and AX parameters corresponded significantly with an increase in the airway obstruction stage, as determined by one-way ANOVA . ROC curve analysis revealed that all the IOS parameters studied, except for Fres, were capable of classifying asthmatic airway obstruction. R₅, R_5–20, and Z₅ were the most accurate parameters. Conclusion. IOS provides an accurate, reliable, and patient-friendly technique for classifying asthmatic airway obstruction.

• airway resistance
• asthmatic
• IOS
• ROC
• spirometry