RT Journal Article SR Electronic T1 Characterization of a signal-correction error in a commercial multiple-breath washout device JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 2027 DO 10.1183/13993003.congress-2022.2027 VO 60 IS suppl 66 A1 M Oestreich A1 F Wyler A1 B Etter A1 K Ramsey A1 P Latzin YR 2022 UL http://erj.ersjournals.com/content/60/suppl_66/2027.abstract AB Background: Multiple-breath washout (MBW) is an established technique to assess functional residual capacity (FRC) and ventilation inhomogeneity in the lung. Indirect calculation of nitrogen concentration requires precise calibration and accurate measurement of gas concentrations.Aim: We investigated the accuracy of the carbon dioxide gas concentration used for the calculation of nitrogen concentration in a commercial MBW device (EasyOne Pro LAB, ndd Medizintechnik AG, Switzerland) and its impact on outcomes.Methods: A high-precision calibration gas mixture was used to evaluate carbon dioxide sensor output. We assessed the impact of a corrected CO2 signal on MBW outcomes in a dataset of healthy children (n=8) and adults (n=10) and children with lung disease (n=8).Results: The EasyOne device uses a respiratory quotient-based adjustment to correct the measured carbon dioxide signal for potential long-term changes in sensor output. In 89% of measurements, this resulted in an overestimation of expired nitrogen concentrations (range -0.7 to 1.7%), and consequently MBW outcomes. Correction of the CO2 signal reduced the mean (range) cumulative expired volume by 27.1% (-58.1%; 1.0%), FRC by 11.1% (-21.6%; 1.2%), and lung clearance index by 18.3% (-44.0%; -0.3%). Additionally, within-visit variability was substantially reduced with the corrected signals.Conclusion: Inadequate signal-correction of the measured CO2 concentration in the EasyOne device leads to a non-systematic error in expired nitrogen concentrations and overestimation of test outcomes. Two-point calibration of the CO2 sensor may maintain accurate measurement of gas concentrations and overcome this error.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 2027.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).