Abstract
We are currently limited in our abilities to diagnose, monitor disease status and manage chronic airway disease like asthma and chronic obstructive pulmonary disease (COPD). Conventional lung function measures often poorly reflect patient symptoms or are insensitive to changes, particularly in the small airways where disease may originate or manifest. Novel pulmonary function tests are becoming available which help us better characterise and understand chronic airway disease, and their translation and adoption from the research arena would potentially enable individualised patient care.
In this article, we aim to describe two emerging lung function tests yielding novel pulmonary function indices, the forced oscillation technique (FOT) and multiple breath nitrogen washout (MBNW). With a particular focus on asthma and COPD, this article demonstrates how chronic airway disease mechanisms have been dismantled with the use of the FOT and MBNW. We describe their ability to assess detailed pulmonary mechanics for diagnostic and management purposes including response to bronchodilation and other treatments, relationship with symptoms, evaluation of acute exacerbations and recovery, and telemonitoring. The current limitations of both tests, as well as open questions/directions for further research, are also discussed.
Abstract
Spirometry is used to diagnose and manage airway disease such as asthma and COPD, but relates poorly to symptoms, lacks sensitivity and is effort dependent. FOT and MBNW are emerging clinical lung function tests that help us dismantle disease mechanisms. http://ow.ly/nM0G30nS6Ct
Footnotes
Number 1 in the Series “Dismantling Airway Disease” Edited by Sinthia Bosnic-Anticevich and Marc Humbert
Provenance: Submitted article, peer reviewed.
Author contributions: S.C. Zimmermann, K.O. Tonga and C. Tharmin contributed to the preparation of the manuscript. All authors have read and approved the final manuscript.
Conflict of interest: S.C. Zimmermann has nothing to disclose.
Conflict of interest: K.O. Tonga has nothing to disclose.
Conflict of interest: C. Thamrin has a patent (WO 2006130922 A1) issued and intellectual property arrangements with two FOT device companies, Thorasys Medical Systems and Restech srl relating to scientific collaborations, but does not have any financial relationships with either company.
- Received December 22, 2018.
- Accepted February 15, 2019.
- Copyright ©ERS 2019.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.