The small airways, also referred to as the lung's silent zone, are closely associated with poor symptom control and more frequent asthma exacerbations. The oscillometry technique superimposes sound or airwaves onto normal tidal breathing and provides information on resistance and reactance, that is, obstacles to airflow occurring inside and outside of the bronchi. More recently, a management paradigm based on so-called "treatable traits" has been proposed to personalize and improve asthma care for individuals by proactively identifying and targeting modifiable pulmonary, extrapulmonary, and behavioral traits affecting asthma control. In this review article, we evaluate the literature on small airways dysfunction as a potential treatable trait in persistent asthma. In particular, we discuss whole- and intrabreath oscillometry and the impact of extrafine inhaled corticosteroids and systemic biologics on the peripheral airways.
- MeSH
- bronchiální astma * patofyziologie farmakoterapie diagnóza MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- lidé MeSH
- oscilometrie * metody MeSH
- plíce patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- interpretace statistických dat MeSH
- lidé MeSH
- oscilometrie metody MeSH
- pediatrie * MeSH
- pletysmografie metody MeSH
- respirační funkční testy * metody MeSH
- spirometrie metody přístrojové vybavení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Chronická obstrukční plicní nemoc (CHOPN) je léčitelná, ale nevyléčitelná choroba, charakterizovaná mimo jiné ireverzibilními změnami dýchacích cest a plicního parenchymu. Poškození dýchacích cest kouřením je zjistitelné roky předtím, než dojde k rozvoji klinicky manifestní CHOPN. Pro detekci těchto časných změn lze využít řadu metod, pro plošné vyšetřování rizikové populace je však řada z nich nevyužitelná kvůli své invazivitě, radiační zátěži či vysoké ceně. Článek je přehledem metod funkčního vyšetření využitelných k záchytu časné CHOPN v rizikové populaci.
Chronic obstructive pulmonary disease (COPD) is a treatable, but chronic illness characterized by irreversible changes in the airways and lung parenchyma. Dysfunction of the small airways related to smoking is detectable years before COPD diagnosis is established. Vast array of methods can be used for such detection; use of some is, however, limited by their cost, availability or invasiveness. This article lists and discusses methods of pulmonary function testing best suitable for early COPD detection in at-risk population.
- MeSH
- časná diagnóza MeSH
- chronická obstrukční plicní nemoc * diagnóza MeSH
- lidé MeSH
- oscilometrie metody MeSH
- spirometrie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- ambulantní monitorování krevního tlaku metody přístrojové vybavení MeSH
- fibrilace síní diagnóza prevence a kontrola MeSH
- hypertenze prevence a kontrola MeSH
- lidé MeSH
- měření krevního tlaku * metody přístrojové vybavení MeSH
- oscilometrie MeSH
- srdeční arytmie * diagnóza prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
OBJECTIVES: This study compared Doppler and oscillometric (PetMAP+) devices (with or without proprietary optimisations) for the non-invasive measurement of blood pressure in conscious cats. METHODS: Twenty-three cats were enrolled; however, five were excluded as fewer than five measurements were obtained for each assessment. All measurements were obtained according to American College of Veterinary Internal Medicine consensus guidelines. Oscillometric device modes A and B were operated according to the manufacturer's guidelines. Doppler and oscillometric devices were used alternately as the first device. RESULTS: Systolic arterial blood pressure (SAP) measurements were obtained by Doppler (SAPd) and oscillometry; the mean of each set of five values was used for statistical analysis. There was a significant difference between SAPd and SAP measurements in oscillometric modes A (P <0.001) and B (P <0.001). While both modes measured SAP higher than SAPd, B had a smaller bias (+15.72 mmHg) and narrower limits of agreement (LOA). There was also a significant difference between SAPd and mean arterial pressure (MAP) on oscillometric modes A (P = 0.002) and B (P <0.001). Both modes' MAP readings were lower than SAPd and oscillometric A MAP was closer to SAPd (-14.94 mmHg), with a smaller bias and narrower LOA. CONCLUSIONS AND RELEVANCE: The findings support that Doppler and oscillometric devices cannot be used interchangeably, with or without proprietary optimisations. Methodology should always be taken into account and reference intervals (RIs) need to be defined for the different methodologies. Until methodology-specific RIs are published, definitive diagnosis of hypertension and sub-staging of patients with kidney disease according to the International Renal Interest Society guidelines remains challenging.
Cardiovascular diseases are the most common cause of death in developed countries. Blood measurement is an integral part of the diagnosis of these diseases. With the development of oscillometric blood pressure monitors, the question of regular monitoring of their clinical accuracy (overall error) has arisen. This paper deals with the overall accuracy of two commercial tonometers (Hartmann Digital HG 160 comfort and HuBDIC HBP–1520), using two calibrated blood pressure simulators (Fluke BP Pump 2 and Fluke ProSim). Using the Wilcoxon rank-sum test, significant differences between the simulators have been proved for all measurements—both for SBP and DBP measurements and both for Hartmann Digital HG 160 and HuBDIC HBP–1520 tonometers (p < 0.001). Therefore, without the precise knowledge of the relationship between the blood pressure monitor and the simulator used, it is not appropriate to use simulators to determine the overall error. On the other hand, the tested devices had a very good repeatability of the measurements at all presets, with both simulators. From this point of view, it is suitable to use simulators to determine the stability of measurement by a given tonometer rather than its clinical accuracy.
- MeSH
- automatizace MeSH
- lidé MeSH
- měření krevního tlaku * metody MeSH
- monitory krevního tlaku MeSH
- oscilometrie metody MeSH
- reprodukovatelnost výsledků MeSH
- sfygmomanometry MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
Aim: We analyzed to what extent measurement protocol influenced individual blood pressure (BP) and achievement of treatment target in patients with coronary heart disease. Methods: In a subsample of Czech EUROASPIRE III-V survey participants (n = 913), we compared the per-protocol BP measurement (by automated oscillometric device OMRON at the beginning of survey procedure) with control auscultatory measurement (by physician during interview). Results: Per-protocol approach produced significantly (p < 0.0001) higher BP values (by 9/6 mmHg in median) than auscultatory measurements and led to markedly higher proportion of patients over target BP (less than 140/90 mmHg; 59.3 vs 34.9% [p < 0.0001], per-protocol vs auscultatory technique, respectively). Conclusion: Per-protocol oscillometric technique was not equivalent to conventional auscultatory measurement and seriously over-rated the real nonachievement of BP target in observational surveys.
- MeSH
- klinické protokoly MeSH
- krevní tlak MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku metody MeSH
- oscilometrie MeSH
- průřezové studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
BACKGROUND: Although invasively measured blood pressure (invBP) is regarded as a "gold standard" in critically ill cardiac patients, the non-invasive BP is still widely used, at least at the initiation of medical care. The erroneous interpretation of BP can lead to clinical errors. We therefore investigated the agreement of both methods with respect to some common clinical situation. METHODS: We included 85 patients hospitalized for cardiogenic shock. We measured BP every 6 h for the first 72 h of hospitalization, in all patients. Each set of BP measurements included two invasive (invBP), two auscultatory (auscBP), and two oscillometric (oscBP) BP measurements. InvBP was considered as a gold standard. Mean non-invasive arterial pressure (MAP) was calculated as (diastolic pressure + (pulse pressure ÷ 3)). We used Bland-Altman analysis and we calculated concordance correlation coefficients to assess agreement between different BP methods. RESULTS: We obtained 967 sets of BP measurements. AuscMAP and oscMAP were on average only 0.4 ± 8.2 and 1.8 ± 8.5 mmHg higher than invMAP, respectively. On the other hand, auscSBP and oscSBP were on average - 6.1 ± 11.4 and - 4.1 ± 9.8 mmHg lower than invSBP, respectively. However, the mean differences and variability for systolic and diastolic BP variability were large; the 2 standard deviation differences were ± 24 and 18 mmHg. In hypotension, non-invasive BP tended to be higher than invBP while the opposite was true for high BP values. Clinical conditions associated with hypotension generally worsened the accuracy of non-invasive MAP. CONCLUSIONS: Mean arterial pressure measured non-invasively appears to be in good agreement with invasive MAP in patients admitted for cardiogenic shock. Several clinical associated with hypotension can affect accuracy of non-invasive measurement. Auscultatory and oscillometric measurements had similar accuracy even in patients with arrhythmia.
- MeSH
- arteriální tlak * MeSH
- časové faktory MeSH
- kardiogenní šok diagnóza patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku metody MeSH
- oscilometrie MeSH
- poslech MeSH
- prediktivní hodnota testů MeSH
- příjem pacientů * MeSH
- prospektivní studie MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- bolest etiologie MeSH
- diagnostické techniky kardiovaskulární klasifikace MeSH
- diagnostické zobrazování klasifikace MeSH
- diferenciální diagnóza MeSH
- lidé MeSH
- onemocnění periferních arterií * diagnóza farmakoterapie klasifikace terapie MeSH
- oscilometrie MeSH
- stupeň závažnosti nemoci MeSH
- vazokonstriktory aplikace a dávkování farmakologie klasifikace MeSH
- Check Tag
- lidé MeSH
