Document Detail

Multiple-breath inert gas washout and spirometry versus structural lung disease in cystic fibrosis.
MedLine Citation:
PMID:  17675316     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A sensitive and valid non-invasive marker of early cystic fibrosis (CF) lung disease is sought. The lung clearance index (LCI) from multiple-breath washout (MBW) is known to detect abnormal lung function more readily than spirometry in children and teenagers with CF, but its relationship to structural lung abnormalities is unknown. A study was undertaken to determine the agreements between LCI and spirometry, respectively, with structural lung disease as measured by high-resolution computed tomography (HRCT) in children and teenagers with CF. METHODS: A retrospective study was performed in 44 consecutive patients with CF aged 5-19 years (mean 12 years). At an annual check-up inspiratory and expiratory HRCT scans, LCI and spirometric parameters (forced expiratory volume in 1 s (FEV1) and maximal expiratory flow when 75% of forced vital capacity was expired (FEF75)) were recorded. Abnormal structure was defined as a composite HRCT score of >5%, the presence of bronchiectasis or air trapping >30%. Abnormal lung function was defined as LCI above the predicted mean +1.96 residual standard deviations (RSD), or FEV1 or FEF75 below the predicted mean -1.96 RSD. Sensitivity/specificity assessments and correlation analyses were done. RESULTS: The sensitivity to detect abnormal lung structure was 85-94% for LCI, 19-26% for FEV1 and 62-75% for FEF75. Specificity was 43-65% for LCI, 89-100% for FEV1 and 75-88% for FEF75. LCI correlated better with HRCT scores (Rs +0.85) than FEV1 (-0.62) or FEF75 (-0.66). CONCLUSIONS: LCI is a more sensitive indicator than FEV1 or FEF75 for detecting structural lung disease in CF, and a normal LCI almost excludes HRCT abnormalities. The finding of an abnormal LCI in some patients with normal HRCT scans suggests that LCI may be even more sensitive than HRCT scanning for detecting lung involvement in CF.
P M Gustafsson; P A De Jong; H A W M Tiddens; A Lindblad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-03
Journal Detail:
Title:  Thorax     Volume:  63     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-31     Completed Date:  2008-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  129-34     Citation Subset:  IM    
Queens Silvia Children's Hospital and Department of Pediatrics, The Sahlgrenska Academy at Göteborg, Sweden.
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MeSH Terms
Breath Tests / methods
Bronchiectasis / complications,  diagnosis*,  physiopathology
Child, Preschool
Cross-Sectional Studies
Cystic Fibrosis / complications*,  physiopathology,  radiography
Forced Expiratory Volume / physiology
Lung / abnormalities,  pathology*,  ultrasonography
Respiratory Function Tests / methods*
Retrospective Studies
Sensitivity and Specificity
Spirometry / methods
Tomography, X-Ray Computed / methods
Comment In:
Thorax. 2008 Feb;63(2):96-7   [PMID:  18234652 ]

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