Kathryn A Ramsey1,2,3, Rachel E Foong1, Jasmine Grdosic1, Alana Harper1, Billy Skoric4,5, Charles Clem6, Miriam Davis6, Lidija Turkovic1, Stephen M Stick1,2,7, Stephanie D Davis6, Sarath C Ranganathan4,5,8, Graham L Hall1,2,9. 1. 1 Telethon Kids Institute, Subiaco, Western Australia, Australia. 2. 2 Centre for Child Health Research, University of Western Australia, Crawley, Western Australia, Australia. 3. 3 Cystic Fibrosis Research and Treatment Centre, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 4. 4 Murdoch Children's Research Institute, Parkville, Victoria, Australia. 5. 5 Department of Respiratory Medicine, Royal Children's Hospital, Parkville, Victoria, Australia. 6. 6 Section of Pediatric Pulmonology, Allergy and Sleep Medicine, Department of Pediatrics, Riley Children's Hospital, Indiana University School of Medicine, Indianapolis, Indiana. 7. 7 Department of Respiratory Medicine, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia. 8. 8 Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia; and. 9. 9 School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia, Australia.
Abstract
RATIONALE: The lung clearance index is a measure of ventilation distribution derived from the multiple-breath washout technique. The lung clearance index is increased in the presence of lower respiratory tract inflammation and infection in infants with cystic fibrosis; however, the associations during the preschool years are unknown. OBJECTIVES: We assessed the ability of the lung clearance index to detect the presence and extent of lower respiratory tract inflammation and infection in preschool children with cystic fibrosis. METHODS: Ventilation distribution outcomes were assessed at 82 visits with 58 children with cystic fibrosis and at 38 visits with 31 healthy children aged 3-6 years. Children with cystic fibrosis also underwent bronchoalveolar lavage fluid collection for detection of lower respiratory tract inflammation and infection. Associations between multiple-breath washout indices and the presence and extent of airway inflammation and infection were assessed using linear mixed effects models. RESULTS: Lung clearance index was elevated in children with cystic fibrosis (mean [SD], 8.00 [1.45]) compared with healthy control subjects (6.67 [0.56]). In cystic fibrosis, the lung clearance index was elevated in individuals with lower respiratory tract infections (difference compared with uninfected [95% confidence interval], 0.62 [0.06, 1.18]) and correlated with the extent of airway inflammation. CONCLUSIONS: These data suggest that the lung clearance index may be a useful surveillance tool for monitoring the presence and extent of lower airway inflammation and infection in preschool children with cystic fibrosis.
RATIONALE: The lung clearance index is a measure of ventilation distribution derived from the multiple-breath washout technique. The lung clearance index is increased in the presence of lower respiratory tract inflammation and infection in infants with cystic fibrosis; however, the associations during the preschool years are unknown. OBJECTIVES: We assessed the ability of the lung clearance index to detect the presence and extent of lower respiratory tract inflammation and infection in preschool children with cystic fibrosis. METHODS: Ventilation distribution outcomes were assessed at 82 visits with 58 children with cystic fibrosis and at 38 visits with 31 healthy children aged 3-6 years. Children with cystic fibrosis also underwent bronchoalveolar lavage fluid collection for detection of lower respiratory tract inflammation and infection. Associations between multiple-breath washout indices and the presence and extent of airway inflammation and infection were assessed using linear mixed effects models. RESULTS: Lung clearance index was elevated in children with cystic fibrosis (mean [SD], 8.00 [1.45]) compared with healthy control subjects (6.67 [0.56]). In cystic fibrosis, the lung clearance index was elevated in individuals with lower respiratory tract infections (difference compared with uninfected [95% confidence interval], 0.62 [0.06, 1.18]) and correlated with the extent of airway inflammation. CONCLUSIONS: These data suggest that the lung clearance index may be a useful surveillance tool for monitoring the presence and extent of lower airway inflammation and infection in preschool children with cystic fibrosis.
Authors: Jeffrey S Wagener; Stefanie J Millar; Nicole Mayer-Hamblett; Gregory S Sawicki; Edward F McKone; Christopher H Goss; Michael W Konstan; Wayne J Morgan; David J Pasta; Richard B Moss Journal: J Cyst Fibros Date: 2017-10-31 Impact factor: 5.482
Authors: Rachel E Foong; Alana J Harper; Billy Skoric; Louise King; Lidija Turkovic; Miriam Davis; Charles C Clem; Tim Rosenow; Stephanie D Davis; Sarath Ranganathan; Graham L Hall; Kathryn A Ramsey Journal: ERJ Open Res Date: 2018-02-16
Authors: Banafshe Hosseini; Bronwyn S Berthon; Malcolm R Starkey; Adam Collison; Rebecca F McLoughlin; Evan J Williams; Kristy Nichol; Peter Ab Wark; Megan E Jensen; Carla Rebeca Da Silva Sena; Katherine J Baines; Joerg Mattes; Lisa G Wood Journal: Front Immunol Date: 2021-06-17 Impact factor: 7.561