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Consensus statement for inert gas washout measurement using multiple- and single- breath tests

Paul D. Robinson, Philipp Latzin, Sylvia Verbanck, Graham L. Hall, Alexander Horsley, Monika Gappa, Cindy Thamrin, Hubertus G.M. Arets, Paul Aurora, Susanne I. Fuchs, Gregory G. King, Sooky Lum, Kenneth Macleod, Manuel Paiva, Jane J. Pillow, Sarath Ranganathan, Felix Ratjen, Florian Singer, Samatha Sonnappa, Janet Stocks, Padmaja Subbarao, Bruce R. Thompson, Per M. Gustafsson
European Respiratory Journal 2013 41: 507-522; DOI: 10.1183/09031936.00069712
Paul D. Robinson
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  • For correspondence: dr.pdrobinson@gmail.com
Philipp Latzin
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Sylvia Verbanck
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Graham L. Hall
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Alexander Horsley
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Monika Gappa
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Cindy Thamrin
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Hubertus G.M. Arets
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Paul Aurora
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Susanne I. Fuchs
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Gregory G. King
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Sooky Lum
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Kenneth Macleod
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Manuel Paiva
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Jane J. Pillow
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Sarath Ranganathan
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Felix Ratjen
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Florian Singer
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Samatha Sonnappa
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Janet Stocks
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Padmaja Subbarao
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Bruce R. Thompson
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Per M. Gustafsson
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This article has a correction. Please see:

  • “Consensus statement for inert gas washout measurement using multiple- and single-breath tests.” Paul D. Robinson, Philipp Latzin, Sylvia Verbanck, Graham L. Hall, Alexander Horsley, Monika Gappa, Cindy Thamrin, Hubertus G.M. Arets, Paul Aurora, Susanne I. Fuchs, Gregory G. King, Sooky Lum, Kenneth Macleod, Manuel Paiva, Jane J. Pillow, Sarath Ranganathan, Felix Ratjen, Florian Singer, Samatha Sonnappa, Janet Stocks, Padmaja Subbarao, Bruce R. Thompson and Per M. Gustafsson. Eur Respir J 2013; 41: 507–522. - November 01, 2013

Abstract

Inert gas washout tests, performed using the single- or multiple-breath washout technique, were first described over 60 years ago. As measures of ventilation distribution inhomogeneity, they offer complementary information to standard lung function tests, such as spirometry, as well as improved feasibility across wider age ranges and improved sensitivity in the detection of early lung damage. These benefits have led to a resurgence of interest in these techniques from manufacturers, clinicians and researchers, yet detailed guidelines for washout equipment specifications, test performance and analysis are lacking. This manuscript provides recommendations about these aspects, applicable to both the paediatric and adult testing environment, whilst outlining the important principles that are essential for the reader to understand. These recommendations are evidence based, where possible, but in many places represent expert opinion from a working group with a large collective experience in the techniques discussed.

Finally, the important issues that remain unanswered are highlighted. By addressing these important issues and directing future research, the hope is to facilitate the incorporation of these promising tests into routine clinical practice.

  • Adult
  • lung function
  • monitoring
  • paediatric
  • validation

Footnotes

  • After publication of the erratum in the November 2013 issue of the European Respiratory Journal, the online version of this article has been revised.

  • For editorial comments see page 500.

  • This article has supplementary material available from www.erj.ersjournals.com

  • Statement of Interest

    Statement of interest for P.D. Robinson, M. Gappa, G.G. King, J.J. Pillow, and F. Ratjen can be found at www.erj.ersjournals.com/site/misc/statements.xhtml

  • ©ERS 2013
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Consensus statement for inert gas washout measurement using multiple- and single- breath tests
Paul D. Robinson, Philipp Latzin, Sylvia Verbanck, Graham L. Hall, Alexander Horsley, Monika Gappa, Cindy Thamrin, Hubertus G.M. Arets, Paul Aurora, Susanne I. Fuchs, Gregory G. King, Sooky Lum, Kenneth Macleod, Manuel Paiva, Jane J. Pillow, Sarath Ranganathan, Felix Ratjen, Florian Singer, Samatha Sonnappa, Janet Stocks, Padmaja Subbarao, Bruce R. Thompson, Per M. Gustafsson
European Respiratory Journal Mar 2013, 41 (3) 507-522; DOI: 10.1183/09031936.00069712

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Consensus statement for inert gas washout measurement using multiple- and single- breath tests
Paul D. Robinson, Philipp Latzin, Sylvia Verbanck, Graham L. Hall, Alexander Horsley, Monika Gappa, Cindy Thamrin, Hubertus G.M. Arets, Paul Aurora, Susanne I. Fuchs, Gregory G. King, Sooky Lum, Kenneth Macleod, Manuel Paiva, Jane J. Pillow, Sarath Ranganathan, Felix Ratjen, Florian Singer, Samatha Sonnappa, Janet Stocks, Padmaja Subbarao, Bruce R. Thompson, Per M. Gustafsson
European Respiratory Journal Mar 2013, 41 (3) 507-522; DOI: 10.1183/09031936.00069712
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  • Article
    • Abstract
    • INTRODUCTION
    • MECHANISMS OF VENTILATION DISTRIBUTION INHOMOGENEITY
    • SBW AND MBW TESTS
    • EQUIPMENT SPECIFICATIONS
    • VALIDATION OF WASHOUT EQUIPMENT
    • SUITABILITY OF CURRENT WASHOUT SYSTEMS ACROSS AGE GROUPS
    • OUTCOMES
    • IMPACT OF INERT GAS CHOICE
    • ACCEPTABILITY CRITERIA FOR TESTING
    • FUTURE WORK AND CONCLUSIONS
    • Acknowledgments
    • Footnotes
    • REFERENCES
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