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Impact of different breathing protocols on multiple-breath washout outcomes in children


Yammine, Sophie; Singer, Florian; Gustafsson, Per; Latzin, Philipp (2014). Impact of different breathing protocols on multiple-breath washout outcomes in children. Journal of Cystic Fibrosis, 13(2):190-197.

Abstract

BACKGROUND: To standardize multiple-breath washout (MBW) measurements, 1L tidal volume (VT) protocols were suggested. The effect on MBW derived ventilation inhomogeneity (VI) indices is unclear.
METHODS: We compared VI indices from free breathing MBW at baseline to 1L VT MBW performed in triplicates in 35 children (20 with CF). Mean (range) age was 12.8 (7.0-16.7) years, weight 42 (20-64) kg and height 151 (117-170) cm.
RESULTS: Baseline lung clearance index (LCI) increased from mean (SD) 11.0 (2.2) to 13.0 (2.6), p = 0.011, in CF and from 6.8 (0.5) to 7.7 (1.4), p = 0.004, in controls. Moment ratio and Scond similarly increased. While change in VI indices was heterogeneous in individuals, decrease in functional residual capacity was most strongly associated with LCI increase.
CONCLUSION: MBW protocols strongly influence measures of VI. The 1L VT MBW protocol leads to overestimation of VI and is not recommended in children.

Abstract

BACKGROUND: To standardize multiple-breath washout (MBW) measurements, 1L tidal volume (VT) protocols were suggested. The effect on MBW derived ventilation inhomogeneity (VI) indices is unclear.
METHODS: We compared VI indices from free breathing MBW at baseline to 1L VT MBW performed in triplicates in 35 children (20 with CF). Mean (range) age was 12.8 (7.0-16.7) years, weight 42 (20-64) kg and height 151 (117-170) cm.
RESULTS: Baseline lung clearance index (LCI) increased from mean (SD) 11.0 (2.2) to 13.0 (2.6), p = 0.011, in CF and from 6.8 (0.5) to 7.7 (1.4), p = 0.004, in controls. Moment ratio and Scond similarly increased. While change in VI indices was heterogeneous in individuals, decrease in functional residual capacity was most strongly associated with LCI increase.
CONCLUSION: MBW protocols strongly influence measures of VI. The 1L VT MBW protocol leads to overestimation of VI and is not recommended in children.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:March 2014
Deposited On:12 Feb 2015 14:21
Last Modified:05 Apr 2016 19:02
Publisher:Elsevier
ISSN:1569-1993
Publisher DOI:https://doi.org/10.1016/j.jcf.2013.08.010
PubMed ID:24075581

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