Pōkole

He ʻano hana hou a ʻaʻole invasive ka Impulse Oscillometry (IOS) no ka loiloi ʻana i ka hana o ka māmā. ʻAʻole e like me ka spirometry maʻamau, kahi e koi ai i nā hana hoʻomaha ikaika a me ke kōkua nui ʻana o ka mea maʻi, ana ʻo IOS i ka impedance hanu i ka wā o ka hanu mālie. ʻO kēia ka mea e lilo ai ia i mea waiwai nui no ka hoʻohana ʻana i nā keiki, ka poʻe ʻelemakule, a me nā mea maʻi i hiki ʻole ke hana i ka spirometry hilinaʻi. Hōʻike kēia ʻatikala i nā loina, nā palena koʻikoʻi, nā noi lapaʻau, nā pono, a me nā palena o IOS i ka lāʻau lapaʻau hanu hou.

Hoʻolauna

He mea nui nā hoʻokolohua hana pulmonary (PFTs) no ka ʻike ʻana a me ka mālama ʻana i nā maʻi hanu. ʻO ka Spirometry, ke kūlana gula, he mau palena ma muli o kona hilinaʻi ʻana i ka hoʻoikaika a me ka hoʻonohonoho ʻana o ka mea maʻi. Ua kū mai ka Impulse Oscillometry (IOS) ma ke ʻano he ʻano hana ikaika a hoʻopihapiha e lanakila ai i kēia mau pilikia ma o ka koi ʻana i ka hanu passive wale nō.

Nā Kumumanaʻo o ka Impulse Oscillometry

Hoʻopili ka ʻōnaehana IOS i nā hōʻailona kaomi pōkole, pulsed (loaʻa kahi spectrum o nā alapine haʻahaʻa a kiʻekiʻe, maʻamau mai 5 a 35 Hz) i nā alaloa o ka mea maʻi ma o kahi waha. Ana ka hāmeʻa i ka hopena o ke kaomi a me ke kahe ʻana o nā hōʻailona ma ka waha. Ma ka hoʻopili ʻana i kahi kumumanaʻo e like me ke kānāwai o Ohm i nā mea uila, helu ia i ka Respiratory Impedance (Z).

Ua haku ʻia ka Impedance Respiratory i ʻelua mau ʻāpana nui:

Ke kū'ē (R)ʻO ka ʻāpana o ka impedance i ka pae me ke kahe. Hōʻike nui ia i nā waiwai resistive o nā alaloa i ke kahe ʻana o ka ea. ʻO nā alapine kiʻekiʻe (e laʻa, 20Hz) e komo i waenakonu, e hōʻike ana i ke kū'ē ʻana o ke alaloa waena, ʻoiai ʻo nā alapine haʻahaʻa (e laʻa, 5Hz) e komo hohonu, e hōʻike ana i ke kū'ē holoʻokoʻa o ke alaloa.

Ka pane ʻana (X)ʻO ka ʻāpana o ka impedance ma waho o ke ʻano me ke kahe. Hōʻike ia i ka recoil elastic o ka ʻiʻo māmā a me ka paia umauma (capacitance) a me nā waiwai inertial o ka ea ma nā alaloa waena (inertance).

Nā Palena Koʻikoʻi a me ko lākou Koʻikoʻi Lapaʻau

R5: Ke kū'ē ma 5 Hz, e hōʻike ana i ke kū'ē hanu holoʻokoʻa.

R20: Ke kū'ē ma 20 Hz, e hōʻike ana i ke kū'ē ʻana o ke alaea waena.

R5 – R20: ʻO ka ʻokoʻa ma waena o R5 a me R20 he hōʻailona koʻikoʻi ia o ke kū'ē ʻana o ke alaea peripheral a i ʻole ke kū'ē ʻana o ke alaea liʻiliʻi. ʻO ka hoʻonui ʻia o ka waiwai e hōʻike ana i ka hana pono ʻole o ke alaea liʻiliʻi.

Fres (Resonant Frequency): ʻO ke alapine (frequency) kahi i ʻole ai ka reactance. ʻO ka piʻi ʻana o Fres e hōʻike ana i ka hoʻonui ʻia ʻana o ke ālai ʻana a me ka paʻakikī o nā māmā, kahi hōʻailona o ka maʻi alaea liʻiliʻi.

AX (Reactance Area): ʻO ka wahi i hoʻohui ʻia o ka reactance mai 5 Hz a i Fres. ʻO ka hoʻonui ʻana o AX he hōʻailona koʻikoʻi ia o ka hemahema o ke alaloa peripheral.

ʻO ka Oscillation Hoʻoikaika vs. Impulse Oscillation i ka hoʻāʻo ʻana i ka hana o ka puʻuwai

ʻO ke ʻano hana hoʻoneʻe ikaika (FOT) a me ka Impulse Oscillometry (IOS) he mau ʻano hana ʻole-invasive e ana i ka impedance hanu i ka wā hanu mālie. ʻO ka ʻokoʻa nui aia i ke ʻano o ka hōʻailona a lākou e hoʻohana ai e hoʻopilikia i ka ʻōnaehana hanu.

1. ʻAno Hana Hoʻoikaika ʻia (FOT)

ʻO ka Hōʻailona:Hoʻohana i hoʻokahi alapine maʻemaʻe a i ʻole ka hui ʻana o nā alapine i wehewehe mua ʻia (multi-frequency) i ka manawa like. He nalu sinusoidal mau kēia hōʻailona.

ʻAno koʻikoʻi:He ana kūlana paʻa ia. No ka mea hiki iā ia ke hoʻohana i hoʻokahi alapine (frequency), he pololei loa ia no ke ana ʻana i ka impedance ma kēlā alapine kikoʻī.

2. ʻO ka Impulse Oscillometry (IOS)

ʻO ka Hōʻailona:Hoʻohana i nā nalu kaomi pōkole loa, e like me ka pulse. He nalu huinaha kēlā me kēia pulse nona kahi spectrum o nā alapine he nui (maʻamau mai 5Hz a 35Hz).

ʻAno koʻikoʻi:He ana kuʻuna ia. ʻO kahi pōmaikaʻi nui, ʻo ka pulse hoʻokahi e hāʻawi i ka ʻikepili impedance ma nā alapine ākea me ka aneane koke.

I ka hōʻuluʻulu manaʻo, ʻoiai he waiwai nā ʻano hana ʻelua, ʻoi aku ka wikiwiki o ke ʻano hana pulsed a IOS, ʻoi aku ka launa pū me ka mea maʻi, a he kūpono loa ia i ka ʻike ʻana i nā maʻi ala liʻiliʻi, e kōkua ana i kona hoʻohana ākea ʻia ʻana ma ke ʻano lapaʻau.

Nā Pōmaikaʻi o IOS

Ka Hana Pū ʻana o ka Mea Maʻi me ka Liʻiliʻi LoaʻO ka hanu mālie wale nō ka mea e pono ai, he mea kūpono ia no nā keiki ʻōpio, ka poʻe ʻelemakule, a me nā poʻe maʻi koʻikoʻi.

Loiloi piha: Hoʻokaʻawale ma waena o ke ālai ʻana o ke alaloa waena a me ke alaloa ʻē aʻe a hāʻawi i ka ʻike e pili ana i ka hoʻokō ʻana o ka māmā.

Ka ʻIke Kiʻekiʻe no ka Maʻi Alanui LiʻiliʻiHiki ke ʻike i nā ʻano ʻē i loko o nā ala ea liʻiliʻi ma mua o ka spirometry.

Maikaʻi loa no ka nānā ʻanaʻAe i nā ana hana hou a lōʻihi, pono no nā hoʻokolohua pilikia bronchial, nā hoʻokolohua pane bronchodilator, a me ka nānā ʻana i ka wā hiamoe a i ʻole ka anesthesia.

Nā Noi Lapaʻau

Pediatric Pulmonology: ʻO ke noi nui, ʻoiai no ka ʻike ʻana a me ka nānā ʻana i ka hānō i nā keiki ʻōpio.

Asthma: Hōʻike ʻia e ka R5 kiʻekiʻe a me ka pane bronchodilator koʻikoʻi. Hoʻohana ʻia ʻo IOS e nānā i ka pono o ka lāʻau lapaʻau a ʻike i nā maʻi i kāohi ʻole ʻia ma o nā palena liʻiliʻi o ke alaea (R5-R20, AX).

ʻO ka maʻi ʻōpū hanu mau loa (COPD): Hōʻike i ke kū'ē kiʻekiʻe a me ka hana ʻino o ke alaea liʻiliʻi (hoʻonui ʻia ʻo R5-R20, Fres, a me AX).

Nā Maʻi Mama Interstitial (ILD): Hoʻopilikia nui i ka reactance, e hana ana i kahi X5 maikaʻi ʻole a me kahi Fres kiʻekiʻe, e hōʻike ana i ka emi ʻana o ka mālama ʻana o ka māmā (nā māmā paʻakikī).

Ka Loiloi Ma mua o ke ʻoki ʻana a me ka Nānā ʻana I loko o ke ʻoki ʻana: Hāʻawi i kahi loiloi wikiwiki o ka hana o ka māmā a hiki ke ʻike i ka bronchospasm koʻikoʻi i ka wā o ke ʻoki ʻana.

Ka Loiloi ʻana o ka Dyspnea Wehewehe ʻole: Kōkua i ka hoʻokaʻawale ʻana ma waena o nā ʻano obstructive a me nā restrictive.

Hopena

He ʻenehana akamai a maʻalahi hoʻi ka Impulse Oscillometry i hoʻololi i ka hoʻāʻo ʻana i ka hana pulmonary, ʻoi aku hoʻi i nā heluna kanaka kahi i paʻakikī ai ka spirometry. ʻO kona hiki ke ʻike i nā maʻi ea liʻiliʻi a hāʻawi i kahi loiloi ʻokoʻa o nā mechanics ea e lilo ia i mea hana waiwai nui no ka ʻike mua ʻana, phenotyping, a me ka hoʻokele lōʻihi o nā ʻano maʻi hanu like ʻole. ʻOiai e hoʻopiha ana ia ma mua o ka pani ʻana i nā PFT maʻamau, ua hoʻopaʻa ʻo IOS i kahi kuleana mau loa a ulu i ka arsenal diagnostics hanu hou.