title: Multiple breath washout with a sidestream ultrasonic flow sensor and mass spectrometry: a comparative study.
abstract: Over recent years, there has been renewed interest in the multiple breath wash-out (MBW) technique for assessing ventilation inhomogeneity (VI) as a measure of early lung disease in children. While currently considered the gold standard, use of mass spectrometry (MS) to measure MBW is not commercially available, thereby limiting widespread application of this technique. A mainstream ultrasonic flow sensor was marketed for MBW a few years ago, but its use was limited to infants. We have recently undertaken intensive modifications of both hardware and software for the ultrasonic system to extend its use for older children. The aim of the current in vivo study was to compare simultaneous measurements of end-tidal tracer gas concentrations and lung clearance index (LCI) from this modified ultrasonic device with those from a mass spectrometer. Paired measurements of three MBW, using 4% sulfur hexafluoride (SF(6)) as the tracer gas and the two systems in series, were obtained in nine healthy adult volunteers. End-tidal tracer gas concentrations (n = 675 paired values) demonstrated close agreement (95% CI of difference -0.23; -0.17%, r(2) = 1). FRC was slightly higher from the MS (95%CI 0.08;0.17 L), but there was no difference in LCI (95%CI -0.10; 0.3). We conclude, that this ultrasonic prototype system measures end-tidal tracer gas concentration accurately and may therefore be a valid tool for MBW beyond early childhood. This prototype system could be the basis for a commercial device allowing more widespread application of MBW in the near future.
authors.affiliation: Department of Paediatric Pulmonology and Neonatology, Medizinische Hochschule, Hannover, Germany.
authors.forename: Susanne I
authors.initials: SI
authors.lastname: Fuchs
authors.forename: Christian
authors.initials: C
authors.lastname: Buess
authors.forename: Sooky
authors.initials: S
authors.lastname: Lum
authors.forename: Wanda
authors.initials: W
authors.lastname: Kozlowska
authors.forename: Janet
authors.initials: J
authors.lastname: Stocks
authors.forename: Monika
authors.initials: M
authors.lastname: Gappa
mesh_terms: D000328:Adult; D001944:Breath Tests / Q000295:instrumentation; D002245:Carbon Dioxide / Q000032:analysis*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D013058:Mass Spectrometry / Q000379:methods*; D012016:Reference Values; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000295:instrumentation*
chemical_list: D002245:Carbon Dioxide