Clinical Applications of Impulse Oscillometry

Impulse oscillometry is a noninvasive procedure that can be performed within few minutes. The purpose of the procedure is to measure the resistance of the small and large airways, as well as the reactants of the airways. It is gradually gaining popularity in evaluating lung function, particularly in patients with asthma and COPD. In contrast to spirometry, the test performs measurement during tidal breathing. In other words, forced exhalation is not required. Other advantages include, but are not limited to, evaluating COPD patients’ reversibility which is rarely noted on spirometry. IOS also is tool for chronic management of patients with asthma and COPD while on treatment. It can evaluate children with asthma even as young as 2 years old. Spirometry requires the child to cooperate and usually is of meaningful use beginning at the age of 5 years old. Other potential applications include early evaluation of transplant rejection, cystic fibrosis, and vocal cord disorder. In this chapter, we will explore the procedure itself, the settings, advantages and disadvantages, and comparative data with spirometry

Newly Diagnosed SLE With APLS and Right Atrial Thrombus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder manifesting in myriad of forms and could affect almost any body system or organ. Antiphospholipid syndrome (APLS) is a relatively common scenario in SLE. Both arterial and venous thrombosis is a hallmark feature of APLS. Among others, intracardiac thrombus is a rare and potentially life-threatening presentation. It could occur in any heart chamber whereas the right atrium is the least common location. The treatment is based on anticoagulation preferably with warfarin along with treatment of SLE. We describe a young patient with newly diagnosed SLE with APLS complicated by right atrial thrombus formation. We are, therefore, adding to the scant literature on right atrial thrombi in SLE and increasing awareness of readers of this serious and potentially deadly condition if left unrecognized