Abstract
Background:
Multiple breath washout (MBW) is an informative but time-consuming test. This study evaluates the uncertainty of a time-saving predictor algorithm in adolescents.
Methods:
Adolescents were recruited from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC2000) birth cohort. MBW trials were performed at 13 y of age with Innocor model Inn00400 using sulfur hexafluoride (SF6) as tracer gas. Measurements were analyzed using a mixed model focusing on two prediction points doubling (t5%) and quadrupling (t10%) the standard end point (t2.5%).
Results:
One hundred and seventy-two MBW trials conducted in 78 adolescents with and without asthma from COPSAC2000 were included. At t10%, the washout time (WoT) was reduced by 41%, and an uncertainty of 0.159 lung clearance index (LCI) units was introduced (±2 SD), ±1.27). At t5%, the WoT was reduced by 25%, with an uncertainty of 0.083 LCI units (±0.558). The optimal prediction point, which led to most saved time and least uncertainty was t5%.
Conclusion:
The predictor algorithm is capable of shortening the MBW test time but introduces an increasing uncertainty with earlier prediction points. This first-of-a-kind prediction algorithm holds promise in shortening the MBW test in children but should be used with caution in subjects with normal LCI values.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Gustafsson PM, De Jong PA, Tiddens HA, Lindblad A. Multiple-breath inert gas washout and spirometry versus structural lung disease in cystic fibrosis. Thorax 2008;63:129–34.
Macleod KA, Horsley AR, Bell NJ, Greening AP, Innes JA, Cunningham S. Ventilation heterogeneity in children with well controlled asthma with normal spirometry indicates residual airways disease. Thorax 2009;64:33–7.
Robinson PD, Latzin P, Verbanck S, et al. Consensus statement for inert gas washout measurement using multiple- and single- breath tests. Eur Respir J 2013;41:507–22.
Gustafsson PM. Inert gas washout in preschool children. Paediatr Respir Rev 2005;6:239–45.
Beydon N, Davis SD, Lombardi E, et al.; American Thoracic Society/European Respiratory Society Working Group on Infant and Young Children Pulmonary Function Testing. An official American Thoracic Society/European Respiratory Society statement: pulmonary function testing in preschool children. Am J Respir Crit Care Med 2007;175:1304–45.
Robinson PD, Goldman MD, Gustafsson PM. Inert gas washout: theoretical background and clinical utility in respiratory disease. Respiration 2009;78:339–55.
Zwitserloot A, Fuchs SI, Müller C, Bisdorf K, Gappa M. Clinical application of inert gas multiple breath washout in children and adolescents with asthma. Respir Med 2014;108:1254–9.
Amin R, Subbarao P, Jabar A, et al. Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax 2010;65:379–83.
Fuchs SI, Eder J, Ellemunter H, Gappa M. Lung clearance index: normal values, repeatability, and reproducibility in healthy children and adolescents. Pediatr Pulmonol 2009;44:1180–5.
Aurora P, Gustafsson P, Bush A, et al. Multiple breath inert gas washout as a measure of ventilation distribution in children with cystic fibrosis. Thorax 2004;59:1068–73.
Yammine S, Singer F, Abbas C, Roos M, Latzin P. Multiple-breath washout measurements can be significantly shortened in children. Thorax 2013;68:586–7.
Bisgaard H. The Copenhagen Prospective Study on Asthma in Childhood (COPSAC): design, rationale, and baseline data from a longitudinal birth cohort study. Ann Allergy Asthma Immunol 2004;93:381–9.
Gonem S, Singer F, Corkill S, Singapuri A, Siddiqui S, Gustafsson P. Validation of a photoacoustic gas analyser for the measurement of functional residual capacity using multiple-breath inert gas washout. Respiration 2014;87:462–8.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307–10.
Author information
Authors and Affiliations
Corresponding author
PowerPoint slides
Rights and permissions
About this article
Cite this article
Grønbæk, J., Hallas, H., Arianto, L. et al. New time-saving predictor algorithm for multiple breath washout in adolescents. Pediatr Res 80, 49–53 (2016). https://doi.org/10.1038/pr.2016.57
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/pr.2016.57
This article is cited by
-
Feasibility and clinical applications of multiple breath wash-out (MBW) testing using sulphur hexafluoride in adults with bronchial asthma
Scientific Reports (2020)
-
Multiple breath washout testing in adults with pulmonary disease and healthy controls – can fewer measurements eventually be more?
BMC Pulmonary Medicine (2017)
