Total respiratory impedance measured by means of the forced oscillation technique in subjects with and without respiratory complaints

Abstract

The purpose of this study was to determine whether the forced oscillation technique is more sensitive than spirometry to detect lung function alterations in subjects with respiratory complaints. The input impedance of the respiratory system (between 2 and 24 Hz) and maximal expiratory flows and volumes were measured in 1,255 subjects referred for routine spirometry. A questionnaire concerning respiratory complaints was administered. A discriminant analysis was performed between subgroups of subjects without (137 males and 140 females), with moderate (115 males and 109 females) and with marked respiratory complaints (149 males and 132 females). A clear-cut separation was achieved by this analysis only between those subjects without and with marked complaints. Both lung volumes and flows as well as impedance parameters (mean value and frequency dependence of resistance in females, mean resistance in males) contributed to the discrimination of subjects without and with marked respiratory complaints, although there was only a moderate decrease of discriminative power when the impedance parameters were excluded. The contribution of the forced oscillation parameters to discriminative power was larger in females than in males (40 vs 19%), which may be related to the higher prevalence of asthma in our population of females. Excluding the subjects with marked functional impairment improved the share of forced oscillation parameters only slightly with respect to lung volumes and flows (females 54 vs males 23%). Considered separately, however, the sensitivity of spirometry and forced oscillation technique to detect symptomatic people appeared to be similar. We conclude that impedance measurements by forced oscillation technique and routine spirometry are both associated with respiratory complaints. Our results indicate that the information provided by impedance measurements can be complimentary to that obtained by spirometric indices.