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Oscillation Mechanics, Integer and Fractional Respiratory Modeling in COPD: Effect of Obstruction Severity.

Abstract：

Purpose:This research examines the emerging role of respiratory oscillometry associated with integer (InOr) and fractional order (FrOr) respiratory models in the context of groups of patients with increasing severity. The contributions to our understanding of the respiratory abnormalities along the course of increasing COPD severity and the diagnostic use of this method were also evaluated. Patients and Methods:Forty-five individuals with no history of smoking or pulmonary diseases (control group) and 141 individuals with diagnoses of COPD were studied, being classified into 45 mild, 42 moderate, 36 severe and 18 very severe cases. Results:This study has shown initially that the course of increasing COPD severity was adequately described by the model parameters. This resulted in significant and consistent correlations among these parameters and spirometric indexes. Additionally, this evaluation enhanced our understanding of the respiratory abnormalities in different COPD stages. The diagnostic accuracy analyses provided evidence that hysteresivity, obtained from FrOr modeling, allowed a highly accurate identification in patients with mild changes [area under the receiver operator characteristic curve (AUC)= 0.902]. Similar analyses in groups of moderate and severe patients showed that peripheral resistance, derived from InOr modeling, provided the most accurate parameter (AUC=0.898 and 0.998, respectively), while in very severe patients, traditional, InOr and FrOr parameters were able to reach high diagnostic accuracy (AUC>0.9). Conclusion:InOr and FrOr modeling improved our knowledge of the respiratory abnormalities along the course of increasing COPD severity. In addition, the present study provides evidence that these models may contribute in the diagnosis of COPD. Respiratory oscillometry exams require only tidal breathing and are easy to perform. Taken together, these practical considerations and the results of the present study suggest that respiratory oscillometry associated with InOr and FrOr models may help to improve lung function tests in COPD.

journal_name

Int J Chron Obstruct Pulmon Dis

journal_title

International journal of chronic obstructive pulmonary disease

authors

Ribeiro CO,Lopes AJ,de Melo PL

doi

10.2147/COPD.S276690

subject

Has Abstract

pub_date

2020-12-08 00:00:00

pages

3273-3289

eissn

1176-9106

issn

1178-2005

pii

276690

journal_volume

pub_type

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Oscillation Mechanics, Integer and Fractional Respiratory Modeling in COPD: Effect of Obstruction Severity.