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Lung clearance index in adult CF patients: the role of convection-dependent lung units.
MedLine Citation:
PMID:  23100495     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We investigated the extent of convective ventilation heterogeneity contributing to the observed lung clearance index (LCI) values in adult CF, as the result of 2 simulated scenarios: (a) a fixed part of the lungs becoming increasingly less compliant, or, (b) an increasingly greater part of the lung being less compliant.In twenty-five CF patients and 25 matched controls, we computed LCI and also quantified curvilinearity (Curv) of the washout concentration curve, where Curv=0 (linear in semilog plot) reflects homogeneous ventilation, and Curv=1 corresponds to the presence of an infinitesimally slowly emptying lung unit.In the CF group (FEV1:27-100%pred), LCI and Curv averaged 10.3±2.3(SD) and 0.57±0.13(SD), respectively, and were significantly different from control values (6.2±0.4 and 0.18±0.07; both P<0.001); LCI and Curv also correlated (R=+0.67;P<0.001). The average Curv value in the CF group was found compatible with a cumulative volume of underventilated lung of 40-50%, depending on the simulation scenario considered.The degree of washout curvilinearity observed here indicates that a major determinant of the abnormal LCI values observed in adult CF patients is ventilation heterogeneity generated between convection-dependent lung units, while the remainder of LCI abnormality with respect to normal controls potentially represents the small airways within these lung zones.
Authors:
Sylvia Verbanck; Manuel Paiva; Erika Paeps; Daniel Schuermans; Anne Malfroot; Walter Vincken; Eef Vanderhelst
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-25
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  -     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University Hospital UZ Brussel, 1090 Brussels, Belgium.
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