PT  - JOURNAL ARTICLE
AU  - Kenneth Macleod
AU  - Samantha Irving
AU  - Alexandra Adams
AU  - Atul Gupta
AU  - Cara Bossley
AU  - Andrew Bush
AU  - Louise Fleming
TI  - Lung function measured by multiple breath inert gas washout in children with severe asthma (SA) before and after intramuscular triamcinolone
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P1098
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P1098.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P1098.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - IntroductionLung clearance index (LCI) is a measure of ventilation heterogeneity derived from multiple breath washout (MBW) of inert gas. Ventilation heterogeneity indices are increased in children and adults with asthma and can assess changes in conductive and acinar airways (Scond and Sacin respectively). We assessed whether abnormalities in these indices would correct following a dose of intramuscular triamcinolone in children with severe asthma.Method29 children (mean age[range] 12.2 [8 to 16] years) with severe therapy resistant asthma (STRA) were admitted as part of a structured protocol for assessment of steroid response. LCI, exhaled nitric oxide (FeNO), sputum eosinophils and standard spirometry were measured before (visit 1), and one month after (visit 2), a dose of intramuscular triamcinolone.ResultsMean(SD) lung function at visit 1 and 2 are shown in table 1. LCI improved slightly, whereas FEV1, Scond and Sacin did not change. There was a strong correlation between mean FEV1 and mean LCI, however change in FEV1 and LCI was discordant. A significant improvement in exhaled nitric oxide did not correlate with change in LCI.View this table:Change in lung function following triamcinoloneConclusionThis study is the first to demonstrate an improvement in LCI following intramuscular triamcinolone. FEV1 did not improve in this group and LCI correlated poorly with markers of inflammation.