False normal Lung Clearance Index in infants with cystic fibrosis due to software algorithms.

Anagnostopoulou, Pinelopi; Yammine, Sophie; Schmidt, Anne; Korten, Insa Christina Severine; Kieninger, Elisabeth; Mack, Ines; Trachsel, Daniel; Hafen, Gaudenz; Moeller, Alexander; Casaulta Aebischer, Carmen; Latzin, Philipp (2015). False normal Lung Clearance Index in infants with cystic fibrosis due to software algorithms. Pediatric pulmonology, 50(10), pp. 970-977. Wiley-Blackwell 10.1002/ppul.23256

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BACKGROUND Lung clearance index (LCI), a marker of ventilation inhomogeneity, is elevated early in children with cystic fibrosis (CF). However, in infants with CF, LCI values are found to be normal, although structural lung abnormalities are often detectable. We hypothesized that this discrepancy is due to inadequate algorithms of the available software package. AIM Our aim was to challenge the validity of these software algorithms. METHODS We compared multiple breath washout (MBW) results of current software algorithms (automatic modus) to refined algorithms (manual modus) in 17 asymptomatic infants with CF, and 24 matched healthy term-born infants. The main difference between these two analysis methods lies in the calculation of the molar mass differences that the system uses to define the completion of the measurement. RESULTS In infants with CF the refined manual modus revealed clearly elevated LCI above 9 in 8 out of 35 measurements (23%), all showing LCI values below 8.3 using the automatic modus (paired t-test comparing the means, P < 0.001). Healthy infants showed normal LCI values using both analysis methods (n = 47, paired t-test, P = 0.79). The most relevant reason for false normal LCI values in infants with CF using the automatic modus was the incorrect recognition of the end-of-test too early during the washout. CONCLUSION We recommend the use of the manual modus for the analysis of MBW outcomes in infants in order to obtain more accurate results. This will allow appropriate use of infant lung function results for clinical and scientific purposes.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Pneumologie (Pädiatrie)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Anagnostopoulou, Pinelopi; Yammine, Sophie; Korten, Insa Christina Severine; Kieninger, Elisabeth; Mack, Ines; Casaulta Aebischer, Carmen and Latzin, Philipp

Subjects:

600 Technology > 610 Medicine & health

ISSN:

8755-6863

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

André Schaller

Date Deposited:

12 Apr 2016 07:32

Last Modified:

12 Apr 2016 07:32

Publisher DOI:

10.1002/ppul.23256

PubMed ID:

26285162

Uncontrolled Keywords:

cystic fibrosis; infant pulmonary function; multiple breath washout; ultrasonic flowmeter

BORIS DOI:

10.7892/boris.80040

URI:

https://boris.unibe.ch/id/eprint/80040

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