Lung clearance index in cystic fibrosis subjects treated for pulmonary exacerbations.

Sonneveld, Nicole; Stanojevic, Sanja; Amin, Reshma; Aurora, Paul; Davies, Jane; Elborn, J Stuart; Horsley, Alex; Latzin, Philipp; O'Neill, Katherine; Robinson, Paul; Scrase, Emma; Selvadurai, Hiran; Subbarao, Padmaja; Welsh, Liam; Yammine, Sophie; Ratjen, Felix (2015). Lung clearance index in cystic fibrosis subjects treated for pulmonary exacerbations. European respiratory journal, 46(4), pp. 1055-1064. European Respiratory Society 10.1183/09031936.00211914

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Pulmonary exacerbations are important clinical events for cystic fibrosis (CF) patients. Studies assessing the ability of the lung clearance index (LCI) to detect treatment response for pulmonary exacerbations have yielded heterogeneous results. Here, we conduct a retrospective analysis of pooled LCI data to assess treatment with intravenous antibiotics for pulmonary exacerbations and to understand factors explaining the heterogeneous response.A systematic literature search was performed to identify prospective observational studies. Factors predicting the relative change in LCI and spirometry were evaluated while adjusting for within-study clustering.Six previously reported studies and one unpublished study, which included 176 pulmonary exacerbations in both paediatric and adult patients, were included. Overall, LCI significantly decreased by 0.40 units (95% CI -0.60- -0.19, p=0.004) or 2.5% following treatment. The relative change in LCI was significantly correlated with the relative change in forced expiratory volume in 1 s (FEV1), but results were discordant in 42.5% of subjects (80 out of 188). Higher (worse) baseline LCI was associated with a greater improvement in LCI (slope: -0.9%, 95% CI -1.0- -0.4%).LCI response to therapy for pulmonary exacerbations is heterogeneous in CF patients; the overall effect size is small and results are often discordant with FEV1.

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:

Latzin, Philipp and Yammine, Sophie

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0903-1936

Publisher:

European Respiratory Society

Language:

English

Submitter:

André Schaller

Date Deposited:

11 Apr 2016 17:38

Last Modified:

11 Apr 2016 17:38

Publisher DOI:

10.1183/09031936.00211914

PubMed ID:

26160868

BORIS DOI:

10.7892/boris.80042

URI:

https://boris.unibe.ch/id/eprint/80042

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