Source: Annual Congress 2002 - Airway obstruction measurement (FOT - NEP) sleep and lung sound analysis
Disease area: Airway diseases

Abstract

The classification of extrathoracic airway obstruction is traditionally based on either the Empey index (FEV₁/PEF) [Empey, D. W. BMJ 1972; 3: 503-505] or more recently the ratio of FEF50%/FIF50% (F/F). Both these measurements require the performance of maximal flow volume curves (MFVC) which may precipitate acute stridor and respiratory distress. Impulse Oscillometry (IOS) requires minimal patient co-operation and enables the differentiation of central and peripheral respiratory resistance. We compared measurements of MFVC and IOS in 56 consecutive patients (mean age 52 years; range 25-78) referred with goitre associated with thyroid disease. FEV₁/PEF and F/F were determined from three technically acceptable MFVC manoeuvres and R20 (central respiratory resistance) from IOS measurements. Only 3 of the 56 patients had a positive Empey index (>10) with a further 7 having a positive F/F ratio (>100). In contrast IOS detected potentially clinically significant respiratory resistance, classified by an R20 >150% predicted, in 31 of the 56 patients. Thus measurement of respiratory resistance identified 55% of patients as having upper airway obstruction, compared to only 5% using Empey and 18% using F/F.
We conclude that IOS may be more sensitive to traditional methods in the detection of significant upper airway obstruction and that there may be a potential diagnostic role for this technique in this group of patients.

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Citations should be made in the following way:
J. Shakespeare, J. A. Hunt, S. L. Hill (Birmingham, United Kingdom). The role of impulse oscillometry in the detection of upper airway obstruction. Eur Respir J 2002; 20: Suppl. 38, 315

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