PT  - JOURNAL ARTICLE
AU  - Noor Al-Khathlan
AU  - Erol Gaillard
AU  - Caroline Beardsmore
TI  - Ventilation inhomogeneity (VI) and spirometry in response to intravenous antibiotics (IVab) in cystic fibrosis (CF)
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P3609
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P3609.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P3609.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction:The value of Lung Clearance Index (LCI) in assessing CF lung disease is not established. One study found improvement in LCI and FEV1 with IVab.1 Another found improvement in FEV1 only, after inhaled antibiotics.2 Our aim was to compare changes in indices from multi-breath N2 washout (MBNW), including VI in the lung periphery(Sacin, Scond) with changes in FEV1 after 2 weeks antibiotics. Method: Children did spirometry and MBNW in triplicate at start and end of routine IVab. Differences were analysed by paired t-test. Results:Eight children (9-17y) completed all tests. Overall there were no statistically significant changes.View this table:Mean(SD) measurements pre(A) and post(B) antibioticsNo individual changes in FEV1>10% were seen. Taking a change in LCI >5% as clinically significant1, LCI worsened in 4 children and improved in 1. The clinical significance of change in Sacin and Scond is unknown but both increased in 5 and decreased in 3, without concordance. When changes in FEV1 were compared with those in VI indices there was no consistency in the direction or size of change. Conclusion:We found no concordance between FEV1 and MBNW indices after IVab. The changes were small; bigger changes might have led to concordance. In contrast with others, our patients did not improve after antibiotics, perhaps because they were stable at the start and, being younger, had less advanced disease. Ref:1) Robinson P et al 2009 PedPulm; 44:733. (2) Horsley, A. 2009. PhD thesis.