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Alternate gas washout indices: Assessment of ventilation inhomogeneity in mild to moderate pediatric cystic fibrosis lung disease
Author(s) -
Nyilas Sylvia,
Bigler Anja,
Yammine Sophie,
Kieninger Elisabeth,
Rochat Isabelle,
Ramsey Kathryn,
Casaulta Carmen,
Moeller Alexander,
Latzin Philipp,
Singer Florian
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24149
Subject(s) - medicine , spirometry , cystic fibrosis , repeatability , ventilation (architecture) , washout , lung function , nitrogen washout , cardiology , lung disease , lung , pulmonary function testing , nuclear medicine , lung volumes , functional residual capacity , statistics , mathematics , mechanical engineering , asthma , engineering
Normalized phase III slope (Sn III ) indices from multiple breath washout (MBW) estimate ventilation inhomogeneity. Alternate (*) protocols for Sn III indices exist, however the utility of these outcomes in children with mild‐to‐moderate cystic fibrosis (CF) is unknown. Methods We measured nitrogen MBW and spirometry in 135 children (43 controls) aged 4‐18 years. We assessed validity, practicability, and reliability of Sn III protocols. Outcomes included the ability to detect abnormal lung function, test agreement, measurement duration, intra‐test repeatability, and quality. Results Lung clearance index (LCI) was abnormal in 80 (87%), Scond in 55 (60%), Scond* in 17 (19%), Sacin in 10 (11%), Sacin* in 11 (12%), and FEV 1 in 28 (30%). Alternate protocols reduced measurement duration. Agreement of indices to detect abnormal lung function was poor. The quality of analysis and repeatability deteriorated with the alternate technique compared to standard. Conclusion In children with mild‐to‐moderate CF lung disease, alternate protocols seem practical but clinimetric properties of standard Sn III protocols are preferable.