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    The clinical utility of lung clearance index in early cystic fibrosis lung disease is not impacted by the number of multiple-breath washout trials

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    Author
    Foong, RE; Harper, AJ; Skoric, B; King, L; Turkovic, L; Davis, M; Clem, CC; Rosenow, T; Davis, SD; Ranganathan, S; ...
    Date
    2018-01-01
    Source Title
    ERJ Open Research
    Publisher
    EUROPEAN RESPIRATORY SOC JOURNALS LTD
    University of Melbourne Author/s
    Ranganathan, Sarath
    Affiliation
    Paediatrics (RCH)
    Metadata
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    Document Type
    Journal Article
    Citations
    Foong, R. E., Harper, A. J., Skoric, B., King, L., Turkovic, L., Davis, M., Clem, C. C., Rosenow, T., Davis, S. D., Ranganathan, S., Hall, G. L. & Ramsey, K. A. (2018). The clinical utility of lung clearance index in early cystic fibrosis lung disease is not impacted by the number of multiple-breath washout trials. ERJ OPEN RESEARCH, 4 (1), https://doi.org/10.1183/23120541.00094-2017.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256120
    DOI
    10.1183/23120541.00094-2017
    Abstract
    The lung clearance index (LCI) from the multiple-breath washout (MBW) test is a promising surveillance tool for pre-school children with cystic fibrosis (CF). Current guidelines for MBW testing recommend that three acceptable trials are required. However, success rates to achieve these criteria are low in children aged <7 years and feasibility may improve with modified pre-school criteria that accepts tests with two acceptable trials. This study aimed to determine if relationships between LCI and clinical outcomes of CF lung disease differ when only two acceptable MBW trials are assessed. Healthy children and children with CF aged 3-6 years were recruited for MBW testing. Children with CF also underwent bronchoalveolar lavage fluid collection and a chest computed tomography scan. MBW feasibility increased from 46% to 75% when tests with two trials were deemed acceptable compared with tests where three acceptable trials were required. Relationships between MBW outcomes and markers of pulmonary inflammation, infection and structural lung disease were not different between tests with three acceptable trials compared with tests with two acceptable trials. This study indicates that pre-school MBW data from two acceptable trials may provide sufficient information on ventilation distribution if three acceptable trials are not possible.

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