ABSTRACT

The Impulse Oscillometry System (IOS) is a lung function test that assesses the respiratory system impedance (Z) at different frequencies of oscillation. From the Z we can get the resistance Z (R) and reactance (X) that are the forces that must be overcome so that the air can be moved in and out of the respiratory system. By the results of the IOS is possible to know, indirectly, if the functional pattern is compatible with bronchial obstruction or restriction. The IOS is particularly useful in those patients with bronchial obstruction symptoms that have a normal spirometry, or, for uncooperative patients in testing effort dependent. Although there are international guidelines for carrying out the IOS, this document is intended to guide the clinician about the advantages and usefulness of the IOS and facilitate their implementation by describing the procedure that has been standardized in our laboratory. Finally, we propose a simple strategy on the clinical interpretation of the test.

KEYWORDS

Impulse oscillometry system, procedure, pulmonary function test, resistance, impedance, reactance, area of reactance AX.

REFERENCES

1. Vargas-Domínguez C, Gochicoa-Rangel L, Velázquez-Uncal M, et al. Pruebas de función respiratoria, ¿cuál y a quién? Neumol Cir Torax 2011;70(2):101-117.

2. Beydon N, Davis SD, Lombardi E, et al.; American Thoracic Society/European Respiratory Society Working Group on Infant and Young Children Pulmonary Function Testing. An official American Thoracic Society/European Respiratory Society statement: pulmonary function testing in preschool children. Am J Respir Crit Care Med 2007;175(12):1304-1345.

3. Dubois AB, Brody AW, Lewis DH, Burgess BF Jr. Oscillation mechanics of lungs and chest in man. J Appl Physiol 1956;8(6):587-594.

4. Al-Mutairi SS, Sharma PN, Al-Alawi A, Al-Deen JS. Impulse oscillometry: an alternative modality to the conventional pulmonary function test to categorise obstructive pulmonary disorders. Clin Exp Med 2007;7(2):56-64.

5. Smith HJ, Reinhold P, Goldman MD. Forced oscillation technique and impulse oscillometry. Eur Respir Mon 2005;31:72-105.

6. Pride NB. Forced oscillation techniques for measuring mechanical properties of the respiratory system. Thorax 1992;47(4):317-320.

7. Larsen GL, Morgan W, Heldt GP, et al.; Childhood Asthma Research and Education Network of the National Heart, Lung, and Blood Institute. Impulse oscillometry versus spirometry in a long-term study of controller therapy for pediatric asthma. J Allergy Clin Immunol 2009;123(4):861-867.

8. Voter KZ, McBride JT. Diagnostic tests of lung function. Pediatr Rev 1996;17(2):53-63.

9. Edwards CA, Osman LM, Godden DJ, Douglas JG. Wheezy bronchitis in childhood: a distinct clinical entity with lifelong significance? Chest 2003; 124(1):18-24.

10. Ortiz G, Menendez R. The effects of inhaled albuterol and salmeterol in 2- to 5-year-old asthmatic children as measured by impulse oscillometry. J Asthma 2002;39(6):531-536.

11. Vogel J, Smidt U, editors. Impulse oscillometry: analysis of lung mechanics in general practice and the clinical, epidemiological and experimental research. Frankfurt: Verlagsgruppe; 1994.

12. Kim HY, Shin YH, Jung da W, Jee HM, Park HW, Han MY. Resistance and reactance in oscillation lung function reflect basal lung function and bronchial hyperresponsiveness respectively. Respirology 2009;14(7):1035-1041.

13. Malmberg LP1, Mäkelä MJ, Mattila PS, Hammarén-Malmi S, Pelkonen AS. Exercise-induced changes in respiratory impedance in young wheezy children and nonatopic controls. Pediatr Pulmonol 2008;43(6):538-544.

14. Mauer MP, Cummings KR. Impulse oscillometry and respiratory symptoms in World Trade Center responders, 6 years post-9/11. Lung 2010;188(2):107-113.

15. Horsman TA, Duke RK, Davenport PW. Airway response to mannitol challenge in asthmatic children using impulse oscillometry. J Asthma 2009;46(6):600-603.

16. Jee HM, Kwak JH, Jung da W, Han MY. Useful parameters of bronchial hyperresponsiveness measured with an impulse oscillation technique in preschool children. J Asthma 2010;47(3):227-232.

17. Newbury W, Crockett A, Newbury J. A pilot study to evaluate Australian predictive equations for the impulse oscillometry system. Respirology 2008;13(7):1070-1075.

18. Shiota S, Katoh M, Fujii M, Aoki S, Matsuoka R, Fukuchi Y. Predictive equations and the reliability of the impulse oscillatory system in Japanese adult subjects. Respirology 2005;10(3):310-315.

19. Dencker M, Malmberg LP, Valind S, et al. Reference values for respiratory system impedance by using impulse oscillometry in children aged 2-11 years. Clin Physiol Funct Imaging 2006;26(4):247-250.

20. Frei J, Jutla J, Kramer G, Hatzakis GE, Ducharme FM, Davis GM. Impulse oscillometry: reference values in children 100 to 150 cm in height and 3 to 10 years of age. Chest 2005;128(3):1266-1273.

21. Nowowiejska B, Tomalak W, Radliński J, Siergiejko G, Latawiec W, Kaczmarski M. Transient reference values for impulse oscillometry for children aged 3-18 tears. Pediatr Pulmonol 2008;43(12):1193-1197.

22. Lee JY, Seo JH, Kim HY, et al. Reference values of impulse oscillometry and its utility in the diagnosis of asthma in young Korean children. J Asthma 2012;49(8):811-816.

23. Amra B, Soltaninejad F, Golshan M. Respiratory resistance by impulse oscillometry in healthy Iranian children aged 5-19 years. Iran J Allergy Asthma Immunol 2008;7(1):25-29.