RT Journal Article
SR Electronic
T1 Early detection of cystic fibrosis lung disease: multiple-breath washout versus raised volume tests
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 341
OP 347
DO 10.1136/thx.2006.068262
VO 62
IS 4
A1 Lum, Sooky
A1 Gustafsson, Per
A1 Ljungberg, Henrik
A1 Hülskamp, Georg
A1 Bush, Andrew
A1 Carr, Siobhán B
A1 Castle, Rosemary
A1 Hoo, Ah-fong
A1 Price, John
A1 Ranganathan, Sarath
A1 Stroobant, John
A1 Wade, Angie
A1 Wallis, Colin
A1 Wyatt, Hilary
A1 Stocks, Janet
A1 on behalf of the London Cystic Fibrosis Collaboration
YR 2007
UL http://thorax.bmj.com/content/62/4/341.abstract
AB Background: Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from the multiple-breath inert gas washout (MBW) technique, has been shown to detect abnormal lung function more readily than spirometry in preschool children with cystic fibrosis, but whether this holds true during infancy is unknown.Objectives: To compare the extent to which parameters derived from the MBW and the raised lung volume rapid thoraco–abdominal compression (RVRTC) techniques identify diminished airway function in infants with cystic fibrosis when compared with healthy controls.Methods: Measurements were performed during quiet sleep, with the tidal breathing MBW technique being performed before the forced expiratory manoeuvres.Results: Measurements were obtained in 39 infants with cystic fibrosis (mean (SD) age 41.4 (22.0) weeks) and 21 controls (37.0 (15.1) weeks). Infants with cystic fibrosis had a significantly higher respiratory rate (38 (10) vs 32 (5) bpm) and LCI (8.4 (1.5) vs 7.2 (0.3)), and significantly lower values for all forced expiratory flow-volume parameters compared with controls. Girls with cystic fibrosis had significantly lower forced expiratory volume (FEV0.5 and FEF25–75 ) than boys (mean (95% CI girls–boys): –1.2 (–2.1 to −0.3) for FEV0.5 Z score; FEF25–75: –1.2 (–2.2 to −0.15)). When using both the MBW and RVRTC techniques, abnormalities were detected in 72% of the infants with cystic fibrosis, with abnormalities detected in 41% using both techniques and a further 15% by each of the two tests performed.Conclusions: These findings support the view that inflammatory and/or structural changes in the airways of children with cystic fibrosis start early in life, and have important implications regarding early detection and interventions. Monitoring of early lung disease and functional status in infants and young children with cystic fibrosis may be enhanced by using both MBW and the RVRTC.