Interpretation of technical standards for respiratory oscillometry of European Respiratory Society of 2020_Chinese Journal of Evidence-Based Medicine

Authors：

LIANG Xiaolin , GAO Yi ,  ZHENG Jinping

National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory, First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou 510120, P.R.China;

Corresponding author：

ZHENG Jinping, Email: jpzhenggy@163.com

Keywords：

Airway resistance; Respiratory oscillometry; Forced oscillation technique; Impulse oscillometry; Guideline interpretation

DOI：

10.7507/1672-2531.202106116

Video：

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Respiratory oscillometry is a lung function test that measures the mechanical properties of respiratory system by the forced oscillation technique. Oscillometry can be used in those who cannot perform traditional lung function tests, including young children. It is also an important tool to assess small airways function in clinical and research fields. In 2020, the European Respiratory Society published a new technical standard for respiratory oscillometry, which offered updated technical recommendations on the hardware, software, testing protocols and quality control of oscillometry measurements. This paper interpreted the new technical standard, for providing technical suggestions regarding oscillometry measurements in clinical and research settings, and as a reference for developing technical statements and recommendations for oscillometry in China.

Citation： LIANG Xiaolin, GAO Yi, ZHENG Jinping. Interpretation of technical standards for respiratory oscillometry of European Respiratory Society of 2020. Chinese Journal of Evidence-Based Medicine, 2022, 22(1): 19-25. doi: 10.7507/1672-2531.202106116 Copy

1.	Goldman MD, Saadeh C, Ross D. Clinical applications of forced oscillation to assess peripheral airway function. Respir Physiol Neurobiol, 2005, 148(1-2): 179-194.
2.	Dubois AB, Brody AW, Lewis DH, et al. Oscillation mechanics of lungs and chest in man. J Appl Physiol, 1956, 8(6): 587-594.
3.	徐慧, 高怡, 郑劲平. 强迫振荡法支气管激发试验研究进展. 中国实用内科杂志, 2020, 40(12): 1033-1036.
4.	梁知遇, 简文华, 谢燕清, 等. 中国脉冲振荡肺功能正常参考值分析. 国际呼吸杂志, 2020, (10): 737-745.
5.	Oostveen E, MacLeod D, Lorino H, et al. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J, 2003, 22(6): 1026-1041.
6.	King GG, Bates J, Berger KI, et al. Technical standards for respiratory oscillometry. Eur Respir J, 2020, 55(2): 1900753.
7.	Watts JC, Farah CS, Seccombe LM, et al. Measurement duration impacts variability but not impedance measured by the forced oscillation technique in healthy, asthma and COPD subjects. ERJ Open Res, 2016, 2(2): 00094-2015.
8.	Robinson PD, Turner M, Brown NJ, et al. Procedures to improve the repeatability of forced oscillation measurements in school-aged children. Respir Physiol Neurobiol, 2011, 177(2): 199-206.
9.	Udomittipong K, Srisukhon W, Nimmannit A, et al. Respiratory impedance reference values for forced oscillation technique predicted by arm span and height in Thai preschool children. Pediatr Allergy Immunol Pulmonol, 2017, 30(2): 97-102.
10.	Gochicoa-Rangel L, Torre-Bouscoulet L, Martínez-Briseño D, et al. Values of impulse oscillometry in healthy mexican children and adolescents. Respir Care, 2015, 60(1): 119-127.
11.	Hagiwara S, Mochizuki H, Muramatsu R, et al. Reference values for Japanese children's respiratory resistance using the LMS method. Allergol Int, 2014, 63(1): 113-119.
12.	Shackleton C, Barraza-Villarreal A, Chen L, et al. Reference ranges for Mexican preschool-aged children using the forced oscillation technique. Arch Bronconeumol, 2013, 49(8): 326-329.
13.	Calogero C, Simpson SJ, Lombardi E, et al. Respiratory impedance and bronchodilator responsiveness in healthy children aged 2-13 years. Pediatr Pulmonol, 2013, 48(7): 707-715.
14.	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.
15.	Vu LT, Demoulin B, Nguyen YT, et al. Respiratory impedance and response to salbutamol in healthy Vietnamese children. Pediatr Pulmonol, 2008, 43(10): 1013-1019.
16.	Nowowiejska B, Tomalak W, Radliński J, et al. Transient reference values for impulse oscillometry for children aged 3-18 years. Pediatr Pulmonol, 2008, 43(12): 1193-1197.
17.	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.
18.	Frei J, Jutla J, Kramer G, et al. 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.
19.	Malmberg LP, Pelkonen A, Poussa T, et al. Determinants of respiratory system input impedance and bronchodilator response in healthy Finnish preschool children. Clin Physiol Funct Imaging, 2002, 22(1): 64-71.
20.	Hellinckx J, De Boeck K, Bande-Knops J, et al. Bronchodilator response in 3-6.5 years old healthy and stable asthmatic children. Eur Respir J, 1998, 12(2): 438-443.
21.	Ducharme FM, Davis GM, Ducharme GR. Pediatric reference values for respiratory resistance measured by forced oscillation. Chest, 1998, 113(5): 1322-1328.
22.	Ribeiro FCV, Lopes AJ, Melo PL. Reference values for respiratory impedance measured by the forced oscillation technique in adult men and women. Clin Respir J, 2018, 12(6): 2126-2135.
23.	Oostveen E, Boda K, van der Grinten CP, et al. Respiratory impedance in healthy subjects: baseline values and bronchodilator response. Eur Respir J, 2013, 42(6): 1513-1523.
24.	Schulz H, Flexeder C, Behr J, et al. Reference values of impulse oscillometric lung function indices in adults of advanced age. PLoS One, 2013, 8(5): e63366.
25.	Brown NJ, Xuan W, Salome CM, et al. Reference equations for respiratory system resistance and reactance in adults. Respir Physiol Neurobiol, 2010, 172(3): 162-168.
26.	Guo YF, Herrmann F, Michel JP, et al. Normal values for respiratory resistance using forced oscillation in subjects>65 years old. Eur Respir J, 2005, 26(4): 602-608.
27.	Pasker HG, Schepers R, Clément J, et al. Total respiratory impedance measured by means of the forced oscillation technique in subjects with and without respiratory complaints. Eur Respir J, 1996, 9(1): 131-139.
28.	Làndsér FJ, Clément J, Van de Woestijne KP. Normal values of total respiratory resistance and reactance determined by forced oscillations: influence of smoking. Chest, 1982, 81(5): 586-591.
29.	Oostveen E, Dom S, Desager K, et al. Lung function and bronchodilator response in 4-year-old children with different wheezing phenotypes. Eur Respir J, 2010, 35(4): 865-872.
30.	Thamrin C, Gangell CL, Udomittipong K, et al. Assessment of bronchodilator responsiveness in preschool children using forced oscillations. Thorax, 2007, 62(9): 814-819.
31.	Houghton CM, Woodcock AA, Singh D. A comparison of plethysmography, spirometry and oscillometry for assessing the pulmonary effects of inhaled ipratropium bromide in healthy subjects and patients with asthma. Br J Clin Pharmacol, 2005, 59(2): 152-159.
32.	Houghton CM, Woodcock AA, Singh D. A comparison of lung function methods for assessing dose-response effects of salbutamol. Br J Clin Pharmacol, 2004, 58(2): 134-141.
33.	Nielsen KG, Bisgaard H. Discriminative capacity of bronchodilator response measured with three different lung function techniques in asthmatic and healthy children aged 2 to 5 years. Am J Respir Crit Care Med, 2001, 164(4): 554-559.
34.	Bailly C, Crenesse D, Albertini M. Evaluation of impulse oscillometry during bronchial challenge testing in children. Pediatr Pulmonol, 2011, 46(12): 1209-1214.
35.	Bohadana AB, Peslin R, Megherbi SE, et al. Dose-response slope of forced oscillation and forced expiratory parameters in bronchial challenge testing. Eur Respir J, 1999, 13(2): 295-300.
36.	Bouaziz N, Beyaert C, Gauthier R, et al. Respiratory system reactance as an indicator of the intrathoracic airway response to methacholine in children. Pediatr Pulmonol, 1996, 22(1): 7-13.
37.	Hsiue TR, Hsieh AL, Chang HY, et al. Bronchoprovocation test by forced oscillation technique: airway hyperresponsiveness in chronic cough and psychogenic dyspnea subjects. J Formos Med Assoc, 1993, 92(3): 231-236.
38.	Jee HM, Kwak JH, Jung DW, et al. Useful parameters of bronchial hyperresponsiveness measured with an impulse oscillation technique in preschool children. J Asthma, 2010, 47(3): 227-232.
39.	Lebecque P, Spier S, Lapierre JG, et al. Histamine challenge test in children using forced oscillation to measure total respiratory resistance. Chest, 1987, 92(2): 313-318.
40.	McClean MA, Htun C, King GG, et al. Cut-points for response to mannitol challenges using the forced oscillation technique. Respir Med, 2011, 105(4): 533-540.
41.	Pairon JC, Iwatsubo Y, Hubert C, et al. Measurement of bronchial responsiveness by forced oscillation technique in occupational epidemiology. Eur Respir J, 1994, 7(3): 484-489.
42.	Schulze J, Smith HJ, Fuchs J, et al. Methacholine challenge in young children as evaluated by spirometry and impulse oscillometry. Respir Med, 2012, 106(5): 627-634.
43.	van Noord JA, Clement J, van de Woestijne KP, et al. Total respiratory resistance and reactance as a measurement of response to bronchial challenge with histamine. Am Rev Respir Dis, 1989, 139(4): 921-926.

1. Goldman MD, Saadeh C, Ross D. Clinical applications of forced oscillation to assess peripheral airway function. Respir Physiol Neurobiol, 2005, 148(1-2): 179-194.
2. Dubois AB, Brody AW, Lewis DH, et al. Oscillation mechanics of lungs and chest in man. J Appl Physiol, 1956, 8(6): 587-594.
3. 徐慧, 高怡, 郑劲平. 强迫振荡法支气管激发试验研究进展. 中国实用内科杂志, 2020, 40(12): 1033-1036.
4. 梁知遇, 简文华, 谢燕清, 等. 中国脉冲振荡肺功能正常参考值分析. 国际呼吸杂志, 2020, (10): 737-745.
5. Oostveen E, MacLeod D, Lorino H, et al. The forced oscillation technique in clinical practice: methodology, recommendations and future developments. Eur Respir J, 2003, 22(6): 1026-1041.
6. King GG, Bates J, Berger KI, et al. Technical standards for respiratory oscillometry. Eur Respir J, 2020, 55(2): 1900753.
7. Watts JC, Farah CS, Seccombe LM, et al. Measurement duration impacts variability but not impedance measured by the forced oscillation technique in healthy, asthma and COPD subjects. ERJ Open Res, 2016, 2(2): 00094-2015.
8. Robinson PD, Turner M, Brown NJ, et al. Procedures to improve the repeatability of forced oscillation measurements in school-aged children. Respir Physiol Neurobiol, 2011, 177(2): 199-206.
9. Udomittipong K, Srisukhon W, Nimmannit A, et al. Respiratory impedance reference values for forced oscillation technique predicted by arm span and height in Thai preschool children. Pediatr Allergy Immunol Pulmonol, 2017, 30(2): 97-102.
10. Gochicoa-Rangel L, Torre-Bouscoulet L, Martínez-Briseño D, et al. Values of impulse oscillometry in healthy mexican children and adolescents. Respir Care, 2015, 60(1): 119-127.
11. Hagiwara S, Mochizuki H, Muramatsu R, et al. Reference values for Japanese children's respiratory resistance using the LMS method. Allergol Int, 2014, 63(1): 113-119.
12. Shackleton C, Barraza-Villarreal A, Chen L, et al. Reference ranges for Mexican preschool-aged children using the forced oscillation technique. Arch Bronconeumol, 2013, 49(8): 326-329.
13. Calogero C, Simpson SJ, Lombardi E, et al. Respiratory impedance and bronchodilator responsiveness in healthy children aged 2-13 years. Pediatr Pulmonol, 2013, 48(7): 707-715.
14. 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.
15. Vu LT, Demoulin B, Nguyen YT, et al. Respiratory impedance and response to salbutamol in healthy Vietnamese children. Pediatr Pulmonol, 2008, 43(10): 1013-1019.
16. Nowowiejska B, Tomalak W, Radliński J, et al. Transient reference values for impulse oscillometry for children aged 3-18 years. Pediatr Pulmonol, 2008, 43(12): 1193-1197.
17. 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.
18. Frei J, Jutla J, Kramer G, et al. 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.
19. Malmberg LP, Pelkonen A, Poussa T, et al. Determinants of respiratory system input impedance and bronchodilator response in healthy Finnish preschool children. Clin Physiol Funct Imaging, 2002, 22(1): 64-71.
20. Hellinckx J, De Boeck K, Bande-Knops J, et al. Bronchodilator response in 3-6.5 years old healthy and stable asthmatic children. Eur Respir J, 1998, 12(2): 438-443.
21. Ducharme FM, Davis GM, Ducharme GR. Pediatric reference values for respiratory resistance measured by forced oscillation. Chest, 1998, 113(5): 1322-1328.
22. Ribeiro FCV, Lopes AJ, Melo PL. Reference values for respiratory impedance measured by the forced oscillation technique in adult men and women. Clin Respir J, 2018, 12(6): 2126-2135.
23. Oostveen E, Boda K, van der Grinten CP, et al. Respiratory impedance in healthy subjects: baseline values and bronchodilator response. Eur Respir J, 2013, 42(6): 1513-1523.
24. Schulz H, Flexeder C, Behr J, et al. Reference values of impulse oscillometric lung function indices in adults of advanced age. PLoS One, 2013, 8(5): e63366.
25. Brown NJ, Xuan W, Salome CM, et al. Reference equations for respiratory system resistance and reactance in adults. Respir Physiol Neurobiol, 2010, 172(3): 162-168.
26. Guo YF, Herrmann F, Michel JP, et al. Normal values for respiratory resistance using forced oscillation in subjects>65 years old. Eur Respir J, 2005, 26(4): 602-608.
27. Pasker HG, Schepers R, Clément J, et al. Total respiratory impedance measured by means of the forced oscillation technique in subjects with and without respiratory complaints. Eur Respir J, 1996, 9(1): 131-139.
28. Làndsér FJ, Clément J, Van de Woestijne KP. Normal values of total respiratory resistance and reactance determined by forced oscillations: influence of smoking. Chest, 1982, 81(5): 586-591.
29. Oostveen E, Dom S, Desager K, et al. Lung function and bronchodilator response in 4-year-old children with different wheezing phenotypes. Eur Respir J, 2010, 35(4): 865-872.
30. Thamrin C, Gangell CL, Udomittipong K, et al. Assessment of bronchodilator responsiveness in preschool children using forced oscillations. Thorax, 2007, 62(9): 814-819.
31. Houghton CM, Woodcock AA, Singh D. A comparison of plethysmography, spirometry and oscillometry for assessing the pulmonary effects of inhaled ipratropium bromide in healthy subjects and patients with asthma. Br J Clin Pharmacol, 2005, 59(2): 152-159.
32. Houghton CM, Woodcock AA, Singh D. A comparison of lung function methods for assessing dose-response effects of salbutamol. Br J Clin Pharmacol, 2004, 58(2): 134-141.
33. Nielsen KG, Bisgaard H. Discriminative capacity of bronchodilator response measured with three different lung function techniques in asthmatic and healthy children aged 2 to 5 years. Am J Respir Crit Care Med, 2001, 164(4): 554-559.
34. Bailly C, Crenesse D, Albertini M. Evaluation of impulse oscillometry during bronchial challenge testing in children. Pediatr Pulmonol, 2011, 46(12): 1209-1214.
35. Bohadana AB, Peslin R, Megherbi SE, et al. Dose-response slope of forced oscillation and forced expiratory parameters in bronchial challenge testing. Eur Respir J, 1999, 13(2): 295-300.
36. Bouaziz N, Beyaert C, Gauthier R, et al. Respiratory system reactance as an indicator of the intrathoracic airway response to methacholine in children. Pediatr Pulmonol, 1996, 22(1): 7-13.
37. Hsiue TR, Hsieh AL, Chang HY, et al. Bronchoprovocation test by forced oscillation technique: airway hyperresponsiveness in chronic cough and psychogenic dyspnea subjects. J Formos Med Assoc, 1993, 92(3): 231-236.
38. Jee HM, Kwak JH, Jung DW, et al. Useful parameters of bronchial hyperresponsiveness measured with an impulse oscillation technique in preschool children. J Asthma, 2010, 47(3): 227-232.
39. Lebecque P, Spier S, Lapierre JG, et al. Histamine challenge test in children using forced oscillation to measure total respiratory resistance. Chest, 1987, 92(2): 313-318.
40. McClean MA, Htun C, King GG, et al. Cut-points for response to mannitol challenges using the forced oscillation technique. Respir Med, 2011, 105(4): 533-540.
41. Pairon JC, Iwatsubo Y, Hubert C, et al. Measurement of bronchial responsiveness by forced oscillation technique in occupational epidemiology. Eur Respir J, 1994, 7(3): 484-489.
42. Schulze J, Smith HJ, Fuchs J, et al. Methacholine challenge in young children as evaluated by spirometry and impulse oscillometry. Respir Med, 2012, 106(5): 627-634.
43. van Noord JA, Clement J, van de Woestijne KP, et al. Total respiratory resistance and reactance as a measurement of response to bronchial challenge with histamine. Am Rev Respir Dis, 1989, 139(4): 921-926.

Chinese Journal of Evidence-Based Medicine

Interpretation of technical standards for respiratory oscillometry of European Respiratory Society of 2020

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