PT  - JOURNAL ARTICLE
AU  - Sooky Lum
AU  - Samatha Sonnappa
AU  - Per Gustafsson
AU  - Angie Wade
AU  - Paul Aurora
AU  - Ah-Fong Hoo
AU  - Janet Stocks
TI  - Lung growth and ventilation inhomogeneity in health
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2010
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2010.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2010.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from multiple breath washout is more sensitive in detecting early lung disease than spirometry in preschool (PS) and school age (SA) children. In health, LCI appears to be stable in PS and SA children, but has been reported to be slightly higher during infancy. We aimed to develop a reference range for LCI from birth to 19y.Methods: LCI data from two centres using a respiratory mass spectrometer (Amis 2000) & the inert gas SF6, measured using either a mask (0-5y) or mouthpiece (>5y), while supine (infant) or seated, were collated. 485 datasets from 359 healthy subjects (44%boys; 257 from London; 102 from Goteborg; Range: age (0.1-18.7y); height (52-196cm)) were analysed.Results: Height & age were significant predictors of LCI on univariable & multivariable analyses. Mean (SD) LCI was 7.2 (0.5) in infants (0.1-2y); 6.7 (0.6) in PS (3-5y): 6.5 (0.5) in SA (6-12y) and 6.5 (0.5) in those >13y. The inverse relationships between LCI & height or age were not linear, being most marked in the younger years & no longer significant by SA.LCI was not significantly different between centres, after adjusting for height & age.Conclusions: Although LCI is fairly constant from PS years into adolescence, it is significantly higher during early life. Reference ranges to take developmental changes and measurement conditions into account should be developed for better interpretation in children with lung disease.