TY - JOUR T1 - Lung clearance index is a reliable and sensitive measure of airways disease in bronchiectasis JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2257 AU - Stephen Rowan AU - Judy Bradley AU - Madeleine Ennis AU - Alex Horsley AU - Nicholas Bell AU - Per Gustafsson AU - Joseph Stuart Elborn Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2257.abstract N2 - Introduction: In bronchiectasis (BE), there is a need for a sensitive outcome measure that is responsive to interventions, particularly in those with mild disease. FEV1 is insensitive to small airways disease and is often within normal range in BE. Lung clearance index (LCI) is a measure of ventilation inhomogeneity derived from multiple breath washout (MBW). Objective: To assess intra and inter-visit repeatability of LCI and determine the relationship between FEV1 and LCI in stable BE.Methods: Inclusion criteria: HRCT diagnosis of BE within 5 years; clinically stable (>4 weeks no infective symptoms); no features of CF. Participants attended for 2 visits, 2 weeks apart. At each visit they performed MBW in triplicate, using 0.2% SF6 and a modified InnocorTM device. LCI was derived from the mean of at least 2 acceptable washouts. Spirometry was performed to ATS/ERS standards.Results: 30 patients (14M/16F) attended for 2 visits. The mean (SD) age was 56.6 (14) yrs. Mean (SD) FEV1 % predicted was 84.8 (20.7), range (40-117). Mean (SD) LCI was 9.2(1.7) on visit 1 and 9.3(1.9) on visit 2 (normal <7.5). The intra-visit and inter-visit intraclass correlation coefficient was 0.94. LCI negatively correlated with FEV1 (r=-0.73, p<0.001) and FEF25-75 (r=-0.84, p<0.001). Sensitivity of LCI, FEV1 and FEF25-75 for the diagnosis of bronchiectasis by CT was 83%, 40% and 73% respectively.Conclusions: This is the first report of LCI in BE. LCI has good intra and inter-visit repeatability. Across a range of FEV1 there is a strong relationship between LCI and FEV1. LCI is a more sensitive test of lung function than FEV1 and FEF25-75, and is abnormal in the majority of people with BE who have a normal FEV1. ER -