Alternative outcomes for the multiple breath washout in children with CF

Stanojevic, Sanja; Jensen, Renee; Sundaralingam, Dasiga; Salazar, Juliana Giraldo; Yammine, Sophie; Singer, Florian; Latzin, Philipp; Amin, Reshma; Subbarao, Padmaja; Gustafsson, Per; Ratjen, Felix (2015). Alternative outcomes for the multiple breath washout in children with CF. Journal of cystic fibrosis, 14(4), pp. 490-496. Elsevier 10.1016/j.jcf.2014.12.008

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BACKGROUND

The lung clearance index (LCI) measured by multiple-breath washout (MBW) has been proposed as an outcome for clinical trials; however, MBW is time consuming and LCI can be affected by breathing pattern. We aimed to evaluate moment ratios and abbreviated LCI in school-aged children with mild-to-moderate CF lung disease.

METHODS

Using existing data from three studies we assessed the sensitivity of moment ratios and abbreviated LCIs to (i) detect mild-to-moderate CF lung disease and (ii) detect treatment effects after 4weeks of hypertonic saline or dornase alfa inhalation. MBW was measured by respiratory mass spectrometry using 4% "sulphur hexafluoride as a tracer gas.

RESULTS

Compared to the traditional LCI, moment ratios and abbreviated LCIs were similarly sensitive to detect CF lung disease. Moment ratios consistently demonstrated treatment effects, whereas abbreviated LCIs were less sensitive.

CONCLUSIONS

Both moment ratios and abbreviated LCI are suitable to differentiate health from disease. Sensitivity is decreased for abbreviated LCIs in interventional studies in mild CF lung disease.

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