Forced oscillometry technique in the assessment of adults with cystic fibrosis treated for a pulmonary exacerbation, a pilot feasibility study

Introduction Effective management of pulmonary exacerbations (PEx) in cystic fibrosis (CF) is essential to minimise lung damage and reduce morbidity and mortality. Spirometry, the standard tool for lung function assessment in adult people with CF (pwCF), has limitations. Forced Oscillometry Technique (FOT) is an effort-independent method that assesses small airways disease and has been validated in other respiratory conditions. This study evaluated the feasibility and acceptability of implementing FOT during treatment for PEx in adult pwCF. Methods Twelve adult pwCF underwent FOT and spirometry at the start and end of PEx treatment, and at clinically convenient intervals. FOT was also measured before and after physiotherapy-directed airway clearance. A questionnaire assessed patient satisfaction with FOT. Results All patients had spirometry below baseline at PEx onset and small airways dysfunction on FOT. Treatment was associated with improvements in median FEV1pp (5.1%, p = 0.050) and X5 (0.2 cm H 2 O/L/s, p = 0.023), with a significant association between FEV1pp and X5 ( p = 0.004). There was no significant FOT change after airway clearance. Patients rated FOT more favourably than spirometry. Discussion FOT is feasible, well-tolerated, and may complement spirometry in assessing adult pwCF during PEx. Further studies are warranted.