Multiple breath washout: A new and promising lung function test for patients with idiopathic pulmonary fibrosis.

Nyilas, Sylvia Meryl; Schreder, Theresa; Singer, Florian; Pöllinger, Alexander; Geiser, Thomas; Latzin, Philipp; Funke-Chambour, Manuela (2018). Multiple breath washout: A new and promising lung function test for patients with idiopathic pulmonary fibrosis. Respirology, 23(8), pp. 764-770. Wiley 10.1111/resp.13294

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BACKGROUND AND OBJECTIVE Idiopathic pulmonary fibrosis (IPF) is a devastating progressive lung disease affecting the parenchyma. Nitrogen multiple-breath washout (N -MBW) is a lung function test that measures ventilation inhomogeneity, a biomarker of small airway disease. We assessed clinical properties of N -MBW in IPF. METHODS In this prospective cohort pilot study, 25 IPF patients and 25 healthy controls were assessed at baseline and 10 patients at median 6.2 months later. Outcomes included the lung clearance index (LCI) from N -MBW, forced vital capacity (FVC) from spirometry, diffusion capacity of the lungs for carbon monoxide (DL ), bronchiectasis score from computed tomography scans, the Gender-Age-Physiology (GAP score for IPF) stage and death or lung transplantation (LTx). Study end points were feasibility, repeatability, discriminative capacity and correlation with disease severity and structural lung damage. RESULTS All patients were able to perform N -MBW. LCI was repeatable and reproducible. Median (interquartile range (IQR)) LCI in IPF was 11.6 (10.1-13.8) in IPF versus 7.3 (6.9-8.4) in controls (P < 0.0001). LCI correlated with DL corrected for haemoglobin (corrDL ; r = -0.49, P = 0.016), bronchiectasis score (r = 0.45, P = 0.024) and the GAP stage (r = 0.59, P = 0.002), but not with FVC. FVC was not related to bronchiectasis. During follow-up, six patients died and one received LTx. LCI correlated with the latter compound outcome: hazard ratio (95% CI) was 2.43 (1.26; 4.69) per one LCI SD from the patient population. CONCLUSION N -MBW is a feasible, reliable and valid lung function test in IPF. LCI correlates with diffusion impairment, structural airway damage and clinical disease severity. LCI is a promising surveillance tool in IPF that may predict mortality.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Pneumologie (Erwachsene)
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology > DCR Magnetic Resonance Spectroscopy and Methodology (AMSM)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Pneumologie (Pädiatrie)

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Nyilas, Sylvia Meryl; Schreder, Theresa; Singer, Florian; Pöllinger, Alexander; Geiser, Thomas; Latzin, Philipp and Funke-Chambour, Manuela

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1440-1843

Publisher:

Wiley

Language:

English

Submitter:

Nicole Rösch

Date Deposited:

16 Jul 2018 16:54

Last Modified:

14 Jan 2019 14:45

Publisher DOI:

10.1111/resp.13294

PubMed ID:

29573509

Uncontrolled Keywords:

idiopathic pulmonary fibrosis interstitial lung disease lung clearance index lung fibrosis multiple breath washout

BORIS DOI:

10.7892/boris.118576

URI:

https://boris.unibe.ch/id/eprint/118576

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