Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; Division of Occupational and Environmental Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Respir Med. 2018 Mar;136:37-47. doi: 10.1016/j.rmed.2018.01.015. Epub 2018 Jan 31.
To provide an evidence-based review of published data regarding normal range reference values and prediction equations for measurements of respiratory impedance using forced oscillation technique (FOT) and impulse oscillometry (IOs) in adults.
A non-language-restricted search was performed using forced oscillation technique and impulse oscillometry as primary terms. Original research studies reporting respiratory system impedance reference values or prediction equations based on cohorts of ≥100 healthy adults were included. Publications cited in identified studies were also considered for inclusion.
Of 882 publications identified, 34 studies were included: 14 studies of FOT, 19 studies of IOs, and one study of both techniques. Nineteen studies provided prediction equations. Most reports were from Europe (n = 20) and Asia (n = 12) and included relatively small cohorts (median = 264 subjects). Across publications, there was marked variability in performance and technique of impedance measurements. Height and sex emerged as major contributors to available prediction equations. The contribution of weight was more pronounced at the obese end of the weight spectrum. The contribution of age was less clear, and elderly were largely under-represented. Ethnicity likely plays a role, but was under-reported in currently available literature. Inclusion of current and former smokers in some studies further confound the results.
Currently available literature providing reference values and prediction equations for respiratory impedance measurements in adults is limited. Until larger-scale standardized studies are available, the choice of prediction equations should be based on datasets that best represent the target patient population and modality in use within each pulmonary physiology laboratory.
提供一份基于已发表数据的循证综述，内容涉及使用强迫震荡技术（FOT）和脉冲震荡技术（IOS）测量成人呼吸阻抗的正常值参考范围和预测方程。
使用强迫震荡技术和脉冲震荡技术作为主要术语进行非语言限制搜索。纳入了基于≥100 名健康成年人队列报告呼吸阻抗参考值或预测方程的原始研究。还考虑了在已确定的研究中引用的出版物。
在 882 篇已确定的文献中，有 34 项研究被纳入：14 项 FOT 研究、19 项 IOS 研究和 1 项两种技术的研究。19 项研究提供了预测方程。大多数报告来自欧洲（n=20）和亚洲（n=12），且纳入的队列相对较小（中位数=264 例）。在各出版物中，阻抗测量的性能和技术存在明显差异。身高和性别是现有预测方程的主要影响因素。体重的影响在体重谱的肥胖端更为明显。年龄的影响不太明确，老年人的代表性不足。种族可能起作用，但在当前可用的文献中报告不足。一些研究将现吸烟者和前吸烟者纳入其中，进一步混淆了结果。
目前关于成人呼吸阻抗测量的参考值和预测方程的文献有限。在更大规模的标准化研究可用之前，预测方程的选择应基于最能代表目标患者人群和每个肺生理实验室使用的模式的数据集。
