title: Multiple-breath washout as a marker of lung disease in preschool children with cystic fibrosis.
abstract: Sensitive measures of lung function applicable to young subjects are needed to detect early cystic fibrosis (CF) lung disease. Forty children with CF aged 2 to 5 years and 37 age-matched healthy control subjects performed multiple-breath inert gas washout, plethysmography, and spirometry. Thirty children in each group successfully completed all measures, with success on first visit being between 68 and 86% for all three measures. Children with CF had significantly higher lung clearance index (mean [95% CI] difference for CF control 2.7 [1.9, 3.6], p < 0.001) and specific airway resistance (1.65 z-scores [0.96, 2.33], p < 0.001), and significantly lower forced expired volume in 0.5 seconds (-0.49 z-scores [-0.95, -0.03], p < 0.05). Abnormal lung function results were identified in 22 (73%) of 30 children with CF by multiple-breath washout, compared with 14 (47%) of 30 by plethysmography, and 4 (13%) of 30 by spirometry. Children with CF who were infected with Pseudomonas aeruginosa had significantly higher lung clearance index, but no significant difference in other lung function measures, when compared with noninfected children. Most preschool children can perform multiple-breath washout, plethysmography, and spirometry at first attempt. Multiple-breath washout detects abnormal lung function in children with CF more readily than plethysmography or spirometry.
authors.affiliation: Portex Respiratory Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. p.aurora@ich.ucl.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Aurora
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
authors.forename: Per
authors.initials: P
authors.lastname: Gustafsson
authors.forename: Cara
authors.initials: C
authors.lastname: Oliver
authors.forename: Colin
authors.initials: C
authors.lastname: Wallis
authors.forename: John
authors.initials: J
authors.lastname: Price
authors.forename: John
authors.initials: J
authors.lastname: Stroobant
authors.forename: Siobhan
authors.initials: S
authors.lastname: Carr
authors.forename: Janet
authors.initials: J
authors.lastname: Stocks
mesh_terms: D000367:Age Factors; D000403:Airway Resistance / Q000502:physiology; D001944:Breath Tests / Q000379:methods*; D016022:Case-Control Studies; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D005652:Functional Residual Capacity / Q000502:physiology; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D013058:Mass Spectrometry; D008450:Maximal Midexpiratory Flow Rate / Q000502:physiology; D009079:Mucociliary Clearance / Q000502:physiology; D010991:Plethysmography; D011552:Pseudomonas Infections / Q000503:physiopathology; D011550:Pseudomonas aeruginosa / Q000502:physiology; D013147:Spirometry; D013457:Sulfur Compounds
chemical_list: D013457:Sulfur Compounds