title: Home monitoring of within-breath respiratory mechanics by a simple and automatic forced oscillation technique device.
abstract: Spirometry is the gold standard to determine the presence of airflow obstruction, but it requires volitional participation and needs qualified supervision. The forced oscillation technique (FOT) measures respiratory input impedance (Zrs) during spontaneous breathing and it could be useful for unsupervised monitoring of airway obstruction. We developed a FOT device for home monitoring of Zrs which transmits the data through the Internet. Its accuracy, stability and reliability were evaluated in a pilot study measuring the Zrs in the unsupervised self-measurements of five healthy subjects. Finally, to explore the applicability of the concept, 36 consecutive daily home measurements were recorded from one healthy subject and one chronic obstructive pulmonary disease (COPD) patient. The accuracy of the device fulfilled FOT guidelines, and the reliability test showed a mean discrepancy of resistance of 0.10 +/- 0.01 cmH(2)O s L(-1). The data from the healthy subjects demonstrated high repeatability in assessing Zrs. The measurements on the healthy subjects and the patient with COPD suggest the feasibility of unsupervised FOT measurements. The healthy subjects showed minimal daily variations in Zrs, whereas the patient with COPD had large differences in mean values and important fluctuations over day-to-day measurements. The results of the pilot study demonstrate that unsupervised home monitoring of Zrs using the FOT yields accurate and reproducible data. It could provide new insights into the dynamics of airway obstruction and improve the understanding and management of obstructive diseases.
authors.affiliation: Dipartimento di Bioingegneria, Politecnico di Milano University, Italy. raffaele.dellaca@polimi.it
authors.forename: Raffaele L
authors.initials: RL
authors.lastname: Dellacà
authors.forename: Alessandro
authors.initials: A
authors.lastname: Gobbi
authors.forename: Miriam
authors.initials: M
authors.lastname: Pastena
authors.forename: Antonio
authors.initials: A
authors.lastname: Pedotti
authors.forename: Bartolomè
authors.initials: B
authors.lastname: Celli
mesh_terms: D004867:Equipment Design; D019544:Equipment Failure Analysis; D005541:Forced Expiratory Volume; D006801:Humans; D020407:Internet / Q000295:instrumentation*; D009991:Oscillometry / Q000295:instrumentation*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000295:instrumentation*; D015656:Respiratory Mechanics; D012648:Self Care / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D014584:User-Computer Interface