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), pp. 190-197. Elsevier 10.1016/j.jcf.2013.08.010

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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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