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Infant lung function testing: First in vivo report of a novel inert gas washout method to measure LCI

Anna Shawcross, Clare Murray, Jane Kirkby, Katy Pike, Alex Horsley
European Respiratory Journal 2016 48: PA4865; DOI: 10.1183/13993003.congress-2016.PA4865
Anna Shawcross
1Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom
2Department of Paediatric Respiratory Medicine, Royal Manchester Children's Hospital, Manchester, United Kingdom
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Clare Murray
1Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom
2Department of Paediatric Respiratory Medicine, Royal Manchester Children's Hospital, Manchester, United Kingdom
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Jane Kirkby
3Institute of Child Health, UCL, London, United Kingdom
4Respiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom
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Katy Pike
3Institute of Child Health, UCL, London, United Kingdom
4Respiratory Unit, Great Ormond Street Hospital for Children, London, United Kingdom
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Alex Horsley
1Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester, Manchester, United Kingdom
5Manchester Adult Cystic Fibrosis Centre, University Hospital South Manchester, Manchester, United Kingdom
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Abstract

Introduction: The value of lung clearance index (LCI) is well recognised. It is a sensitive measure of lung disease in infants, particularly with cystic fibrosis(CF). Measuring LCI in infants is technically challenging due to the need to accurately combine flow and gas measurements at rapid respiratory rates. There is no simple method of assessing lung function outside research laboratories in this population. We have previously described a novel method of performing inert gas washout, in which expired gas is collected and analysed to derive functional residual capacity (FRC) and LCI without directly measuring flow. This has been demonstrated to be highly accurate in vitro (Ped Pulmonol, 2015).

Aims: We aim to assess the practical applicability and accuracy of the novel method in vivo.

Method: Infants with CF and healthy controls will undergo FRC and LCI measurement using the novel method.The number of successful LCI measurement and within-subject repeatability will be used to assess practical applicability of the system. Comparison will be made with LCI measurements obtained using a respiratory mass spectrometer, currently considered the gold standard for infant LCI measurement.

Results: To date, 3 patients (all healthy, mean age 55 weeks) have successfully undergone the washout process using the novel method. Mean LCI was 6.47 (range 6.14-7.0, CV 8%)

Conclusions: Preliminary data suggest this is a feasible and precise method of performing LCI in infants, with results in healthy children falling within the normal range predicted from the mass spectrometer (Lum, ERJ). Once validation is complete, this could provide a more accessible alternative to previously described systems.

  • Infants
  • Lung function testing
  • Cystic fibrosis
  • Copyright ©the authors 2016
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Infant lung function testing: First in vivo report of a novel inert gas washout method to measure LCI
Anna Shawcross, Clare Murray, Jane Kirkby, Katy Pike, Alex Horsley
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4865; DOI: 10.1183/13993003.congress-2016.PA4865

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Infant lung function testing: First in vivo report of a novel inert gas washout method to measure LCI
Anna Shawcross, Clare Murray, Jane Kirkby, Katy Pike, Alex Horsley
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4865; DOI: 10.1183/13993003.congress-2016.PA4865
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