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The forced oscillation technique in clinical practice: methodology, recommendations and future developments

E. Oostveen, D. MacLeod, H. Lorino, R. Farré, Z. Hantos, K. Desager, F. Marchal
European Respiratory Journal 2003 22: 1026-1041; DOI: 10.1183/09031936.03.00089403
E. Oostveen
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D. MacLeod
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H. Lorino
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R. Farré
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Z. Hantos
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K. Desager
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F. Marchal
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  • Fig. 1.—
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    Fig. 1.—

    (–)(‐‐‐)()-()Schematic illustration of the frequency dependence of respiratory impedance of adults in the medium frequency range, in health and disease. Compared to the normal impedance data , in airway obstruction, respiratory resistance is higher a and negatively frequencydependent, whereas respiratory reactance is lower b. Arrow indicates resonant frequency.

  • Fig. 2.—
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    Fig. 2.—

    (Schematic arrangement of the forced oscillatory respiratory impedance Zrs,in) measurement. Pap: airway opening pressure; V': airflow.

  • Fig. 3.—
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    Fig. 3.—

    (Regression curves or mean values of respiratory resistance Rrs) versus–– height in different studies. : 40–––; : 37---; : 36═; : 35; –– : 41–––; : 44–-–; : 38–--–; : 39------; : 42---; : 34; ═: 45.

  • Fig. 4.—
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    Fig. 4.—

Tables

  • Figures
  • Table 1

    (Overview of the average respiratory resistance Rrs) value obtained in healthy adults.

    ReferenceSelection criteriaFrequency band HzMaleFemale
    Rrs·· kPasL−1nAge yrsRrs·· kPasL−1nAge yrs
    28 /Male Air Force membersapplicants–424()0.25 0.06224()26 10
    29 ?–824∼ 0.2644229
    30 Patients undergoing rehabilitation and healthy hospital workers10()+0.29 0.08 MF10250
    31 ?–624()0.26 0.06126()33 12()0.30 0.06100()29 12
    24 “”Healthy subjects referred for lung function testing–1032()0.26 0.0732()48 15()0.34 0.0728()55 13
    32 “”Healthy subjects referred for lung function testing–624()0.25 0.05137()53 14()0.31 0.07140()58 14
    • (Data are presented as mean sd)

    • M: male

    • F: female

    • n: number of subjects studied

  • Table 2

    (Prediction equations for the average resistance Rrs())(0, average reactance Xrs())(0 and slope of resistance to frequency Rrs())1, and the residual sd( Rsd)

    Male
    Rrs()=−+–+(00.2454.H0.001564.W0.00055.A0.5919 Rsd=)0.0493
    Rrs()=–––(10.00842.H0.000047.W0.000018.A0.0095 Rsd=)0.00197
    Xrs()=–––(00.1479.H0.000402.W0.00022.A0.1721 Rsd=)0.0306
    Female
    Rrs()=−+–+(00.4300.H0.00165.W0.00070.A0.9312 Rsd=)0.0619
    Rrs()=–––(10.01176.H0.000106.W0.000045.A0.00817 Rsd=)0.00256
    Xrs()=–––(00.2487.H0.001700.W0.00053.A0.2158 Rsd=)0.0406
    • Rrs()0 and Xrs()··0 in kPasL−1, Rrs()·1 in kPas2·L−1

    • ()H: height m

    • ()W: weight kg

    • ()A: age yrs

    • Reproduced with permission from 32

  • Table 3

    (Overview of the regression equations of respiratory resistance Rrs) as a function of height in healthy children

    ReferenceFrequency band HzSubjects nAge yrsRrs·· kPasL−1Rsd
    42 –153516–35R(–)rs1535=−×+0.00529H1.102
    41 4, 9130–314Rrs4=–×2.470.013H
    36 –310121–416Rrs4=×1.87104×H–2.12
    38 –226138–216Rrs6=×9.210−5×H2–×+0.0341H3.520.15
    40 2, 4, 12218–218(logRrs4)=–×()4.4132.18log H%10.2
    34 –226255–212Rrs6=×0.00017H2–×+0.05407H4.773230.175
    39 10377–318Rrs10=–×1.3920.00635H0.066
    44 5247–36.5Rrs5=−×+0.009528H2.0643065
    45 8, 12, 16199–317(ln Rrs8)=–×()10.9902.370ln H
    • ()H: height cm

    • Rsd: residual sd

  • Table 4

    ()-()Short term within day intraindividual variability of forced oscillation technique FOT indices in adult, healthy subjects and patients

    ReferenceFOT indexSubjects studied%CV
    48 R rs10 Healthy subjects11.3
    Asthmatics10.3
    49 R rs8 Healthy subjects8.3
    Asthmatics10.0
    50 |Zrs10|Asthmatics4.9
    12 R –rs432 Healthy subjects4.7
    30 R rs10 Healthy subjects9.8
    51 R rs10 Healthy subjects8.6
    COPD patients8.8
    52 R rs6 Patients with airway obstruction15.2
    52 R -rs626 Patients with airway obstruction12.1
    • Rrs6, Rrs8, Rrs10: Rrs  measured at 6, 8 or 10Hz

    • |Zrs10 |: modulus at 10Hz

    • CV: coefficient of variation

  • Table 5
    AbbreviationDescriptionUnit
    aoAirway opening
    awAirway
    bsBody surface
    esOesophageal
    f FrequencyHz
    f res Resonant frequencyHz
    FRCFunction residual capacityL
    G (/Conductance 1R)·LkPa−1·s−1
    Gaw(/Airway conductance 1Raw)·LkPa−1·s−1
    Grs(/Total respiratory conductance 1Rrs)·LkPa−1·s−1
    sGaw(=Specific airway conductance G/)awFRCkPa−1·s−1
    inInput
    LPulmonary system
    P PressurekPa
    R Real part of Z or resistance··kPasL−1
    rsRespiratory system
    R aw Airway resistance measured by body plethysmography··kPasL−1
    sRaw(/Specific airway resistance 1sGaw)·kPas
    R rs f Total respiratory resistance measured at frequency f
    tiTissue
    trTransfer
    V'Airflow·Ls−1
    wChest wall
    X Imaginary part of Z or reactance··kPasL−1
    Z Impedance··kPasL−1
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The forced oscillation technique in clinical practice: methodology, recommendations and future developments
E. Oostveen, D. MacLeod, H. Lorino, R. Farré, Z. Hantos, K. Desager, F. Marchal
European Respiratory Journal Dec 2003, 22 (6) 1026-1041; DOI: 10.1183/09031936.03.00089403

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The forced oscillation technique in clinical practice: methodology, recommendations and future developments
E. Oostveen, D. MacLeod, H. Lorino, R. Farré, Z. Hantos, K. Desager, F. Marchal
European Respiratory Journal Dec 2003, 22 (6) 1026-1041; DOI: 10.1183/09031936.03.00089403
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