Multiple breath inert gas washout as a measure of ventilation distribution in children with cystic fibrosis

被引:213
作者
Aurora, P
Gustafsson, P
Bush, A
Lindblad, A
Oliver, C
Wallis, CE
Stocks, J
机构
[1] Inst Child Hlth, Intens Therapy & Resp Med Univ, London WC1N 1EH, England
[2] Great Ormond St Hosp Sick Children, Cardioresp & Crit Care Div, London WC1N 3JH, England
[3] Sahlgrens Univ Hosp, Queen Silvia Childrens Hosp, S-41345 Gothenburg, Sweden
[4] Royal Brompton Hosp, Dept Paediat Resp Med, London SW3 6LY, England
关键词
D O I
10.1136/thx.2004.022590
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Multiple breath inert gas washout (MBW) has been suggested as a tool for detecting early cystic fibrosis (CF) lung disease. A study was undertaken to compare the relative sensitivity of MBW and spirometry for detecting abnormal lung function in school age children with CF and to compare MBW results obtained from healthy children in the UK with those recently reported from Sweden. Methods: Forced expiratory volume in 1 second (FEV1) and maximal expiratory flow when 25% of forced vital capacity remains to be expired (MEF25) were compared with the lung clearance index (LCI) derived from sulphur hexafluoride MBW in 22 children with CF aged 6-16 years and in 33 healthy controls. Results: LCI was higher in children with CF than in healthy controls (mean difference 5.1 (95% CI of difference 4.1 to 6.1) and FEV1 and MEF25 z-scores were lower (mean difference -2.3 (95% CI -2.9 to -1.7) and -1.8 (95% CI -2.4 to -1.3), respectively; p<0.001 for all). There was a significant negative correlation between LCI and FEV1 (r(2) = 0.62) and MEF25 (r(2) = 0.46). However, while normal (>=-1.96 z-scores) FEV1 and MEF25 results were seen in 11 (50%) and 12 (53%) children with CF, respectively, all but one of these children had an abnormally increased LCI. LCI was repeatable in both groups ( within subject CV for three measurements 6% for CF and 5% for healthy children). In healthy subjects LCI was independent of age and virtually identical in the British and Swedish children (mean difference 0.1 (95% CI -0.1 to 0.4), p = 0.38) Conclusions: MBW is reproducible between laboratories, generates normal ranges which are constant over childhood, and is more frequently abnormal than spirometry in children with CF.
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页码:1068 / 1073
页数:6
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