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Forced oscillation technique in veterans with preserved spirometry and chronic respiratory symptoms
Ryan P Butzko1, Anays M Sotolongo2, Drew A Helmer1
1Airborne Hazards Center of Excellence, War Related Illness and Injury Study Center, Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA; New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA.
Purpose:
To evaluate the utility of the forced oscillation technique (FOT) among military veterans with preserved spirometry and chronic unexplained respiratory symptoms.
Methods:
178 veterans referred for evaluation of unexplained respiratory symptoms completed pulmonary function testing and FOT. Preserved spirometry was defined as FEV1/FVC, FEV1 and FVC ≥ 5th percentile. Frequency dependence of resistance (R4-R20) and reactance area (AX) were assessed via FOT, and R4-R20 ≥ 20% and AX ≥ 95th percentile were considered abnormal.
Results:
Spirometry was preserved in 71.3%, of whom 124 had acceptable FOT data. 93 of 124 (75.0%) veterans with preserved spirometry had one or more abnormal findings on FOT. Veterans with abnormal R4-R20 and/or AX had reduced FVC, FEV1, FEF25-75, and diffusing capacity (% predicted) in comparison to those with Normal FOT (p = 0.030 to p < 0.001).
Conclusions:
In our referral sample, distal airway dysfunction in the presence of preserved spirometry appears common and may represent an at-risk group requiring closer surveillance.
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