Abstract
Impulse oscillometry (IOS) can be used to evaluate airway impedance in patients with obstructive airway diseases. Previous studies have demonstrated that IOS parameters differ between patients with bronchiectasis and healthy controls. This study aims to explore the usefulness of IOS in assessing disease severity and airway reversibility in patients with bronchiectasis. Seventy-four patients with non-cystic fibrosis bronchiectasis who visited our Respiratory Medicine outpatient clinic were consecutively recruited. Spirometry, plethysmography and IOS tests were performed. Patients were stratified into mild, moderate and severe disease according to Reiff, Bhalla, BSI, FACED, and BRICS scores. Airway reversibility was measured by bronchodilation test (BDT) and the result was classified as positive or negative. ROC curves of IOS parameters were used to assess the usefulness of IOS parameters in predicting airway reversibility. Correlations between the IOS, spirometric lung function and bronchiectasis severity parameters were analyzed. Many IOS parameters, such as airway resistance at 5 Hz (R5), small airways resistance (R5-R20), total airway reactance (X5), resonance frequency (Fres), total airway impedance at 5 Hz (Z5), and peripheral resistance (Rp) increased in patients with bronchiectasis who presented a moderate to severe severity as categorized by the FACED, BSI and Reiff scores. Large airway resistance (R20) and central resistance (Rc) were not significantly different among groups with different bronchiectasis severity. The difference between R5 and R20 (R5-R20) showed 81.0% sensitivity, and 69.8%specificity in predicting the airway reversibility in bronchiectasis with AUC of 0.794 (95%CI, 0.672-0.915). IOS measurements are useful indicators of bronchiectasis severity and may be useful for predicting the airway reversibility.
Highlights
Impulse oscillometry (IOS) is a non-invasive and relatively simple method that can be used to detect airway abnormalities
The results demonstrated that as the severity of bronchiectasis increased, IOS parameters resistance at 5 Hz (R5), R5-resistance at 20 Hz (R20), Resonant frequency (Fres), Impedance value at 5 Hz (Z5) and Peripheral resistance (Rp) had the tendency to increase, while the Reactance at 5 Hz (X5) had the tendency to decreased in value
The results of the present study show that IOS parameters that reflect airway resistance and reactance present a tendency to increase based on the severity of bronchiectasis, suggesting that IOS can be useful in the assessment of bronchiectasis severity
Summary
Impulse oscillometry (IOS) is a non-invasive and relatively simple method that can be used to detect airway abnormalities. Bronchiectasis is a chronic airway disease where there is abnormal enlargement of some airways in the lungs This is normally diagnosed by identification of typical radiographic features in high resolution computed tomography (HRCT) scans, such as bronchial enlargement and wall thickening. These changes are consequences of a complex interaction between various factors, including genetic predisposition, airway dysfunction, inflammatory response, structural diseases and chronic infections [2]. Impulse oscillometry (IOS) can be used to evaluate airway impedance in patients with obstructive airway diseases. This study aims to explore the usefulness of IOS in assessing disease severity and airway reversibility in patients with bronchiectasis
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