Validation of Multiple-Breath Washout Equipment: From Bench to Clinic and Possible Pitfalls

Latzin, Philipp; Thompson, Bruce

doi:10.1159/000362420

Cited by 3 publications

(3 citation statements)

References 22 publications

(26 reference statements)

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“…Both IOS and MBN 2 W may be used not only to assess functional abnormalities in the small airways, but also to longitudinally monitor the effects of interventions and pharmacological treatments [Borrill et al 2008;Verbanck et al 1999]. Further studies are being undertaken to determine whether they can be adopted in daily clinical practice [Latzin and Thompson, 2014].…”

Section: Small Airways Assessmentsmentioning

confidence: 99%

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The role of the small airways in the pathophysiology of asthma and chronic obstructive pulmonary disease

Bonini

Usmani

2015

Ther Adv Respir Dis

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Chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), represent a major social and economic burden for worldwide health systems. During recent years, increasing attention has been directed to the role of small airways in respiratory diseases, and their exact contribution to the pathophysiology of asthma and COPD continues to be clarified. Indeed, it has been suggested that small airways play a distinct role in specific disease phenotypes. Besides providing information on small airways structure and diagnostic procedures, this review therefore aims to present updated and evidence-based findings on the role of small airways in the pathophysiology of asthma and COPD. Most of the available information derives from either pathological studies or review articles and there are few data on the natural history of small airways disease in the onset or progression of asthma and COPD. Comparisons between studies on the role of small airways are hard to draw because both asthma and COPD are highly heterogeneous conditions. Most studies have been performed in small population samples, and different techniques to characterize aspects of small airways function have been employed in order to assess inflammation and remodelling. Most methods of assessing small airways dysfunction have been largely confined to research purposes, but some data are encouraging, supporting the utilization of certain techniques into daily clinical practice, particularly for early-stage diseases, when subjects are often asymptomatic and routine pulmonary function tests may be within normal ranges. In this context further clinical trials and real-life feedback on large populations are desirable.

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Section: Small Airways Assessmentsmentioning

confidence: 99%

“…1999]. Further studies are being undertaken to determine whether they can be adopted in daily clinical practice [Latzin and Thompson, 2014].…”

Section: Small Airways Assessmentsmentioning

confidence: 99%

The role of the small airways in the pathophysiology of asthma and chronic obstructive pulmonary disease

Bonini

Usmani

2015

Ther Adv Respir Dis

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“…The availability of commercial equipment and the recently published ERS/ATS consensus statement (Robinson et al 2013) on inert gas washout tests have renewed the interest in the assessment of ventilation inhomogeneity in infants (Latzin and Thompson 2014). Inhomogeneity indices may be more sensitive than other lung function measures for the early detection of small airway disease in infants and these tests may be easier to perform than conventional lung function tests in this population.…”

Section: Introductionmentioning

confidence: 99%

The lung clearance index in young infants: impact of tidal volume and dead space

et al. 2015

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Lung clearance index (LCI), measured by multiple breath washout (MBW), is one of the most frequently used measures of ventilation inhomogeneity. This study was designed to investigate the effect of lung volumes on LCI in young infants. The dependence of LCI on dead space volume (VD), tidal volume (VT) and functional residual capacity (FRC) was investigated by mathematical modeling and by MBW measurements using sulfur hexafluoride (SF6) as a tracer gas. MBW was performed in 150 infants, of median postmenstrual age 46.7 weeks, followed up after neonatal intensive care. Wheezing was assessed in 90 of these infants by computerized respiratory sound analysis during quiet sleep. The strongest correlation was observed between LCI and the volume ratios VT/FRC (Spearman rank order correlation coefficient Rs = 0.688, p < 0.001), VD/VT (Rs = 0.733, p < 0.001) and VD/FRC (Rs = 0.854, p < 0.001). LCI calculated from VD, VT, and FRC was linearly related to measured LCI with a coefficient of determination of 75%. There were no significant differences between wheezers and non-wheezers in postmenstrual age and body weight, but FRC was significantly increased (p < 0.001) and median (interquartile range) LCI significantly decreased (5.83 (5.45-6.51) versus (6.54 (6.03-7.22), p < 0.001) in wheezing compared to non-wheezing infants. Model calculations also showed that LCI was significantly reduced in wheezing infants (5.09 (4.79-5.62) versus 5.43 (5.08-5.82), p < 0.018), indicating that the reduction can be explained by differences in the lung volumes, not by improved ventilation homogeneity. In conclusion, the strong dependence of LCI on lung volumes in young infants can lead to misinterpretations regarding the homogeneity of alveolar ventilation.

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Preschool Multiple-Breath Washout Testing. An Official American Thoracic Society Technical Statement

Robinson¹,

Latzin²,

Ramsey³

et al. 2018

Am J Respir Crit Care Med

113

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Validation of Multiple-Breath Washout Equipment: From Bench to Clinic and Possible Pitfalls

Cited by 3 publications

References 22 publications

The role of the small airways in the pathophysiology of asthma and chronic obstructive pulmonary disease

The role of the small airways in the pathophysiology of asthma and chronic obstructive pulmonary disease

The lung clearance index in young infants: impact of tidal volume and dead space

Preschool Multiple-Breath Washout Testing. An Official American Thoracic Society Technical Statement

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