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Updated: Jul 18, 2025
14:49
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
7.2K
Adding oscillometry to spirometry in guidelines better identifies uncontrolled asthma, future exacerbations, and
Stanley P Galant1, Tricia Morphew2
1Children's Hospital of Orange County, Orange County, California; University of California Irvine, Irvine, California.
Summary
Impulse oscillometry (IOS) can identify peripheral airway impairment (PAI) in asthma, even in well-controlled patients. Early detection of PAI with IOS and targeted therapies can lead to improved asthma control and outcomes.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Medicine
Background:
- Peripheral airway impairment (PAI) is increasingly recognized as a significant factor in asthma.
- Current asthma guidelines may not fully capture PAI in all patients, potentially leading to suboptimal management.
- Impulse oscillometry (IOS) offers a method to assess peripheral airways, complementing traditional spirometry.
Purpose of the Study:
- To review recent advances in understanding the clinical significance of PAI detection using IOS.
- To explore the role of targeted therapies in managing PAI and improving asthma outcomes.
- To evaluate the utility of IOS in identifying uncontrolled asthma and predicting exacerbations.
Main Methods:
- Systematic literature search of PubMed and Google for studies on IOS and asthma.
- Analysis of findings linking PAI, identified by IOS, to asthma control and exacerbations.
- Review of studies on targeted therapies, including extrafine inhaled corticosteroids, for PAI.
Main Results:
- PAI is consistently associated with uncontrolled asthma across diverse ethnicities.
- PAI is prevalent even in patients deemed well-controlled by current guidelines.
- IOS-derived scores (R5-R20, AX, X5) predict asthma control and exacerbations, outperforming FEV1 alone in some analyses.
- Combining FEV1 with PAI assessment enhances the identification of uncontrolled asthma and exacerbations.
- Extrafine inhaled corticosteroids improve peripheral airway function and asthma control more effectively than nonextrafine formulations.
Conclusions:
- IOS is a valuable tool that should be considered for inclusion in future asthma guidelines alongside spirometry.
- Targeted therapies, particularly extrafine inhaled corticosteroids, show promise in managing PAI and improving asthma control.
- Identifying and treating PAI can lead to better asthma outcomes, especially in specific phenotypes like obesity-associated asthma.
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