title: Feasibility of lung clearance index in a clinical setting in pre-school children.
abstract: Lung function testing in pre-school children in the clinical setting is challenging. Most cannot perform spirometry and many infant lung function tests require sedation. Lung clearance index (LCI) derived from the multiple-breath washout (MBW) test has been shown to be sensitive to early disease changes but may be time consuming and so a shortened test (LCI0.5) may be more feasible in young children. We sought to establish feasibility of MBW in unsedated pre-school children in a clinic setting and hypothesised use of LCI0.5would increase success rates.116 pre-school children (28 healthy controls and 88 with respiratory disease), median age 4.0 years (range 2-6 years), underwent MBW tests unsedated in a clinic setting, using sulfur hexafluoride as a tracer gas and an adapted photoacoustic gas analyser.81 (70%) out of 116 children completed LCI and 72% completed LCI0.5measurement. Test success increased significantly in patients over 3 years (0% at <2.5 years, 33% at 2.5-3 years and 70% at >3 years, p<0.0001). LCI was elevated in those with respiratory disease compared with healthy controls.MBW is feasible in a clinic setting in unsedated pre-schoolers, particularly in those >3 years old, and LCI is raised in those with respiratory disease. Use of LCI0.5did not increase success rate in pre-schoolers.
authors.affiliation: NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Barrett
authors.initials: B
authors.lastname: Downing
authors.affiliation: NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Samantha
authors.initials: S
authors.lastname: Irving
authors.affiliation: NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Bingham
authors.affiliation: NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Fleming
authors.affiliation: NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bush
authors.affiliation: NHLI, Imperial College London, and Royal Brompton and Harefield NHS Foundation Trust, London, UK s.saglani@imperial.ac.uk.
authors.forename: Sejal
authors.initials: S
authors.lastname: Saglani
mesh_terms: D000162:Acoustics; D001944:Breath Tests; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000503:physiopathology; D003550:Cystic Fibrosis / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D005541:Forced Expiratory Volume; D005740:Gases; D006801:Humans; D007619:Kartagener Syndrome / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology; D008297:Male; D010045:Outpatients; D015272:Pulmonary Medicine / Q000379:methods; D012008:Recurrence; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D012141:Respiratory Tract Infections / Q000503:physiopathology; D013147:Spirometry; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D013997:Time Factors
chemical_list: D005740:Gases; D013459:Sulfur Hexafluoride