Multiple breath washout: A new and promising lung function test for patients with idiopathic pulmonary fibrosis

Nyilas, Sylvia; Schreder, Theresa; Singer, Florian; Poellinger, Alexander; Geiser, Thomas; Latzin, Philipp; Funke, Manuela

doi:10.1111/resp.13294

Cited by 15 publications

(11 citation statements)

References 37 publications

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“…As both indices have previously been shown to correlate with BOS/BO and GvHD, it could be relevant to include these indices in future studies. However, the high variability of these parameters, that has been demonstrated in previous studies as well, may limit their use as biomarkers.…”

Section: Discussionmentioning

confidence: 96%

Lung clearance index for early detection of pulmonary complications after allo‐HSCT in children

Uhlving

Skov

Buchvald

et al. 2019

Pediatric Pulmonology

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Background: Pulmonary chronic graft-vs-host disease (cGvHD) after hematopoietic stem cell transplantation (HSCT) is characterized by impairment of the small airways. Assessment of lung clearance index (LCI) gained from multiple breath washout (MBW)is more sensitive than spirometry in detection of small airways disease. The aim of this study was to describe the development of LCI during the first year after pediatric HSCT and how LCI relates to other pulmonary function parameters and cGvHD.Methods: This prospective, longitudinal study included 28 pediatric HSCT-recipients.Spirometry, Sulfur hexafluoride MBW and diffusion capacity of the lungs were performed before and at 3, 6, 9, and 12 months after HSCT. Respiratory symptoms and signs of cGvHD were recorded at each visit.Results: Before HSCT, 47.8% had abnormal LCI and 12.5% had abnormal forced expiratory volume in 1 second (FEV 1 ) . Patients with persisting respiratory symptoms 12 months post-HSCT had higher median LCI (factor 5.7, P = 0.0018) and lower FEV 1 z-scores (−1.5, P = 0.033) post-HSCT compared to patients free of respiratory symptoms. Overall, post-HSCT LCI values were 3.49 times higher and FEV 1 was 2.31 z-scores lower in eight patients with cGvHD in any organ system compared with patients without cGvHD (P = 0.0089 and P < 0.0001). LCI values during the first 3 months were not predictive of pulmonary cGvHD.Conclusion: LCI is a sensitive marker for cGvHD and high LCI values were associated with persisting respiratory symptoms after 1 year. Further evaluation of MBW in early detection of HSCT-related pulmonary complications require larger patient cohorts and closer follow-up during the first months after HSCT.

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Section: Discussionmentioning

confidence: 96%

Lung clearance index for early detection of pulmonary complications after allo‐HSCT in children

Uhlving

Skov

Buchvald

et al. 2019

Pediatric Pulmonology

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“…Thus, the ATS/ERS/JRS/ALAT guidelines propose the same strategy of the Fleischner Society Statement when there is a high clinical likelihood of IPF or probable UIP pattern and the experts supported only a ‘conditional recommendation’ for SLB, providing flexibility for clinicians. More studies are needed to raise the likelihood of IPF, and multiple‐breath washout (MBW) seems to be a new and promising lung function test for patients affected by IPF correlating small airway disease with lung damage. The quantitative computed tomography (CT) analysis may also be valuable.…”

Section: Idiopathic Pulmonary Fibrosismentioning

confidence: 99%

Contemporary Concise Review 2018: Interstitial lung disease

2019

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“…This work will support the application of the technique in the clinical setting and add to its ultimate clinical utility. According to B. Thompson, the clinical utility for the device can be demonstrated with published data from studies in asthma, COPD, lung transplantation, haematopoietic stem cell transplantation and idiopathic pulmonary fibrosis disease [16–20].…”

Section: “Pro/con” Debate On Current and Evolving Tests In Lung Functionmentioning

confidence: 99%

European Respiratory Society International Congress 2018: Allied Respiratory Professionals’ report of highlighted sessions

et al. 2019

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This article provides an overview of outstanding sessions that were supported by Assembly 9 during the recent European Respiratory Society International Congress in Paris, France. Session content was mainly targeted at allied health professionals such as respiratory physiologists, respiratory physiotherapists and respiratory nurses. Recent developments and novel findings related to pulmonary function testing, respiratory muscle function assessments and treatment, and multidimensional and multidisciplinary approaches to the assessment and management of dyspnoea were the focus of these sessions and are summarised here.

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Multiple breath washout: A new and promising lung function test for patients with idiopathic pulmonary fibrosis

Abstract: N -MBW is a feasible, reliable and valid lung function test in IPF. LCI correlates with diffusion impairment, structural airway damage and clinical disease severity. LCI is a promising surveillance tool in IPF that may predict mortality.

Cited by 15 publications

References 37 publications

Lung clearance index for early detection of pulmonary complications after allo‐HSCT in children

Lung clearance index for early detection of pulmonary complications after allo‐HSCT in children

Contemporary Concise Review 2018: Interstitial lung disease

European Respiratory Society International Congress 2018: Allied Respiratory Professionals’ report of highlighted sessions

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