Leaks during multiple-breath washout: characterisation and influence on outcomes.

Lenherr, Nina; Ramsey, Kathryn A.; Jost, Kerstin; Hornwall, Linn; Singer, Florian; Yammine, Sophie; Latzin, Philipp (2018). Leaks during multiple-breath washout: characterisation and influence on outcomes. ERJ Open Research, 4(1) European Respiratory Society 10.1183/23120541.00012-2017

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Nitrogen multiple-breath washout (NMBW) is increasingly used in patients with cystic fibrosis. The current European Respiratory Society/American Thoracic Society consensus statement for MBW recommends the rejection of measurements with leaks. However, it is unclear whether this is necessary for all types of leaks. Here, our aim was to 1) model and 2) apply air leaks, and 3) to assess their influence on the primary MBW outcomes of lung clearance index and functional residual capacity. We investigated the influence of air leaks at various locations (pre-, intra- and post-capillary), sizes, durations and stages of the washout. Modelled leaks were applied to existing NMBW data from 10 children by modifying breath tables. In addition, leaks were applied to the equipment during NMBW measurements performed by one healthy adolescent. All modelled and applied leaks resulted in statistically significant but heterogeneous effects on lung clearance index and functional residual capacity. In all types of continuous inspiratory leaks exceeding a certain size, the end of the washout was not reached. For practical application, we illustrated six different "red flags", signs that enable easy identification of leaks during measurements. Air leaks during measurement significantly influence NMBW outcomes. The influence of leaks on MBW outcomes is dependent on the location, relation to breath cycle, duration, stage of washout and size of the leak. We identified a range of signs to help distinguish leaks from physiological noise.

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

UniBE Contributor:

Ramsey, Kathryn Angela; Singer, Florian; Yammine, Sophie and Latzin, Philipp

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2312-0541

Publisher:

European Respiratory Society

Language:

English

Submitter:

Romy Melanie Rodriguez Del Rio

Date Deposited:

08 Jan 2019 16:00

Last Modified:

09 Jan 2019 07:16

Publisher DOI:

10.1183/23120541.00012-2017

PubMed ID:

29497618

BORIS DOI:

10.7892/boris.120760

URI:

https://boris.unibe.ch/id/eprint/120760

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