Lung clearance index and moment ratios at different cut-off values in infant multiple-breath washout measurements.

Egger, Barbara; Jost, Kerstin; Anagnostopoulou, Pinelopi; Yammine, Sophie; Singer, Florian; Casaulta Aebischer, Carmen; Frey, Urs; Latzin, Philipp (2016). Lung clearance index and moment ratios at different cut-off values in infant multiple-breath washout measurements. Pediatric pulmonology, 51(12), pp. 1373-1381. Wiley-Blackwell 10.1002/ppul.23483

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BACKGROUND Multiple-breath washout (MBW) is increasingly used for infant lung function testing. Current guidelines recommend calculating lung clearance index (LCI) and functional residual capacity (FRC) at 2.5% of normalized tracer gas concentration, without clear recommendation for moment ratios (MR). Whether the 2.5% cut-off has the highest discriminative power to detect ventilation inhomogeneity in infants with lung diseases is unknown. METHODS We used sulfur-hexafluoride MBW measurements from 32 infants with cystic fibrosis, 32 preterm infants, and 32 healthy controls at postmenstrual age of 41-54 weeks. We compared the discriminative power to detect pathological values above the upper limit of normal for 12 different cut-offs between 20% and 1.5% for first and second MR (MR1, MR2), LCI, and FRC. RESULTS MR and LCI results changed significantly at different cut-offs. Mean MR2 in infants with cystic fibrosis increased from 2.4 to 7.2 units between 20% and 1.5% SF6 . The ability of MR and LCI to discriminate between health and disease increased significantly with lower cut-offs. The 1.5% cut-off showed highest discriminative power: in infants with cystic fibrosis pathological MR2 values were found in 27 out of 89 (30%) and for LCI in 28/89 (32%). In preterm infants, pathological MR2 values were detected in 39 out of 73 (53%), and for LCI in 35/73 (48%). FRC remained stable throughout the washout. CONCLUSION In infants, the diagnostic performance of MBW strongly depends on the point of analysis. The cut-off with the highest discriminative power to detect ventilation inhomogeneity in infants with cystic fibrosis and after preterm birth was at 1.5% tracer gas concentration. Pediatr Pulmonol. 2016;51:1373-1381. © 2016 Wiley Periodicals, Inc.

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 Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
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:

Anagnostopoulou, Pinelopi; Yammine, Sophie; Singer, Florian; 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:

17 Feb 2017 15:19

Last Modified:

17 Feb 2017 15:19

Publisher DOI:

10.1002/ppul.23483

PubMed ID:

27214661

Uncontrolled Keywords:

infant lung function; lung clearance index; moment ratios; multiple-breath washout

BORIS DOI:

10.7892/boris.92910

URI:

https://boris.unibe.ch/id/eprint/92910

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