Sophie Yammine1,2, Selina Summermatter1,3,4, Florian Singer5, Roger Lauener3,4,6, Philipp Latzin7,8. 1. University Children's Hospital Basel, UKBB, Basel, 4031, Switzerland. 2. Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland. 3. Christine Kühne-Center for Allergy and Research Education, CK-CARE, Davos-Wolfgang, 7265, Switzerland. 4. Hochgebirgsklinik Davos, Davos-Wolfgang, 7265, Switzerland. 5. University Children's Hospital Zurich, Zurich, 8032, Switzerland. 6. Children's Hospital of Eastern Switzerland, St. Gallen, 9000, Switzerland. 7. University Children's Hospital Basel, UKBB, Basel, 4031, Switzerland. philipp.latzin@insel.ch. 8. Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland. philipp.latzin@insel.ch.
Abstract
BACKGROUND: Multiple breath washout (MBW) is an attractive test to assess ventilation inhomogeneity, a marker of peripheral lung disease. Systematic research on MBW feasibility in preschool children is scanty. OBJECTIVES: We assessed feasibility of nitrogen MBW in children aged 3-7 years in a clinical setting applying current ERS/ATS consensus. METHODS: Sixty-two children with asthma were enrolled in the Swiss rehabilitation center Hochgebirgsklinik Davos without MBW experience and prior to consensus release. Age range was 3.1-6.7 years. All children were naïve to MBW, received training, and then aimed for triplicate nitrogen MBW within 20 min. We afterward assessed the number of MBW attempts and successful tests according to consensus asking for three technically acceptable trials with functional residual capacity (FRC) measurements within 25% of median FRC. Secondly, factors related to success rate and FRC variability were assessed. RESULTS: Out of 205 MBW attempts in 62 children, 103 trials (50%) in 51 children were successful. Only 15 children (24%) achieved three valid trials as suggested by consensus. At least two valid trials were obtained in 37 children (60%). Age was positively correlated with success rate. FRC variability was inversely correlated with variability of tidal volume. CONCLUSIONS: MBW was only feasible in one quarter of inexperienced children <7 years applying strict consensus criteria. Low FRC variability and low breathing variability seem to be mutually exclusive at this age group. Specific consensus recommendations for MBW in preschool children seem, thus, warranted. Pediatr Pulmonol. 2016;51:1183-1190.
BACKGROUND:Multiple breath washout (MBW) is an attractive test to assess ventilation inhomogeneity, a marker of peripheral lung disease. Systematic research on MBW feasibility in preschool children is scanty. OBJECTIVES: We assessed feasibility of nitrogen MBW in children aged 3-7 years in a clinical setting applying current ERS/ATS consensus. METHODS: Sixty-two children with asthma were enrolled in the Swiss rehabilitation center Hochgebirgsklinik Davos without MBW experience and prior to consensus release. Age range was 3.1-6.7 years. All children were naïve to MBW, received training, and then aimed for triplicate nitrogen MBW within 20 min. We afterward assessed the number of MBW attempts and successful tests according to consensus asking for three technically acceptable trials with functional residual capacity (FRC) measurements within 25% of median FRC. Secondly, factors related to success rate and FRC variability were assessed. RESULTS: Out of 205 MBW attempts in 62 children, 103 trials (50%) in 51 children were successful. Only 15 children (24%) achieved three valid trials as suggested by consensus. At least two valid trials were obtained in 37 children (60%). Age was positively correlated with success rate. FRC variability was inversely correlated with variability of tidal volume. CONCLUSIONS: MBW was only feasible in one quarter of inexperienced children <7 years applying strict consensus criteria. Low FRC variability and low breathing variability seem to be mutually exclusive at this age group. Specific consensus recommendations for MBW in preschool children seem, thus, warranted. Pediatr Pulmonol. 2016;51:1183-1190.