Multiple breath washout in pediatric patients after lung transplantation.

Nyilas, Sylvia Meryl; Carlens, J; Price, T; Singer, Florian; Müller, C; Hansen, G; Warnecke, G; Latzin, Philipp; Schwerk, N (2018). Multiple breath washout in pediatric patients after lung transplantation. American journal of transplantation, 18(1), pp. 145-153. Wiley-Blackwell 10.1111/ajt.14432

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Forced expiratory volume in 1 second (FEV1 ) from spirometry is the most commonly used parameter to detect early allograft dysfunction after lung transplantation (LTx). There are concerns regarding its sensitivity. Nitrogen-multiple breath washout (N2 -MBW) is sensitive at detecting early global (lung clearance index [LCI]) and acinar (Sacin ) airway inhomogeneity. We investigated whether N2 -MBW indices indicate small airways pathology after LTx in children with stable spirometry. Thirty-seven children without bronchiolitis obliterans syndrome [BOS] at a median of 1.6 (0.6-3.0) years after LTx underwent N2 -MBW and spirometry, 28 of those on 2 occasions (≤6 months apart) during clinically stable periods. Additional longitudinal data (11 and 8 measurements, respectively) are provided from 2 patients with BOS. In patients without BOS, LCI and Sacin were significantly elevated compared with healthy controls. LCI was abnormal at the 2 test occasions in 81% and 71% of patients, respectively, compared with 30% and 39% of patients with abnormal FEV1 /forced vital capacity (FVC). Correlations of LCI with FEV1 /FVC (r = 0.1, P = .4) and FEV1 (r = -0.1, P = .6) were poor. N2 -MBW represents a sensitive and reproducible tool for the early detection of airways pathology in stable transplant recipients. Moreover, indices were highly elevated in both patients with BOS. Spirometry and LCI showed poor correlation, indicating distinct and complementary physiologic measures.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Nyilas, Sylvia Meryl; Singer, Florian and Latzin, Philipp

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1600-6135

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Romy Melanie Rodriguez Del Rio

Date Deposited:

10 Apr 2018 11:27

Last Modified:

24 Oct 2019 21:44

Publisher DOI:

10.1111/ajt.14432

PubMed ID:

28719135

Uncontrolled Keywords:

clinical research/practice lung (native) function/dysfunction lung disease pediatrics

BORIS DOI:

10.7892/boris.109243

URI:

https://boris.unibe.ch/id/eprint/109243

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