Contemporary N 2 and SF 6 multiple breath washout in infants and toddlers with cystic fibrosis

2022 ◽  
Author(s):  
Rikke M. Sandvik ◽  
Per M. Gustafsson ◽  
Anders Lindblad ◽  
Frederik Buchvald ◽  
Hanne Vebert Olesen ◽  
...  
Author(s):  
Rikke Mulvad Sandvik ◽  
Marika Nathalie Schmidt ◽  
Maja Valentin Kragh ◽  
Christian Voldby ◽  
Frederik Buchvald ◽  
...  

2011 ◽  
Vol 46 (7) ◽  
pp. 666-671 ◽  
Author(s):  
Margaret Rosenfeld ◽  
Stephanie Davis ◽  
Lyndia Brumback ◽  
Stephen Daniel ◽  
Ron Rowbotham ◽  
...  

2018 ◽  
Vol 52 (5) ◽  
pp. 1800821 ◽  
Author(s):  
Laurie J. Smith ◽  
Guilhem J. Collier ◽  
Helen Marshall ◽  
Paul J.C. Hughes ◽  
Alberto M. Biancardi ◽  
...  

Hyperpolarised helium-3 (3He) ventilation magnetic resonance imaging (MRI) and multiple-breath washout (MBW) are sensitive methods for detecting lung disease in cystic fibrosis (CF). We aimed to explore their relationship across a broad range of CF disease severity and patient age, as well as assess the effect of inhaled lung volume on ventilation distribution.32 children and adults with CF underwent MBW and 3He-MRI at a lung volume of end-inspiratory tidal volume (EIVT). In addition, 28 patients performed 3He-MRI at total lung capacity. 3He-MRI scans were quantitatively analysed for ventilation defect percentage (VDP), ventilation heterogeneity index (VHI) and the number and size of individual contiguous ventilation defects. From MBW, the lung clearance index, convection-dependent ventilation heterogeneity (Scond) and convection–diffusion-dependent ventilation heterogeneity (Sacin) were calculated.VDP and VHI at EIVT strongly correlated with lung clearance index (r=0.89 and r=0.88, respectively), Sacin (r=0.84 and r=0.82, respectively) and forced expiratory volume in 1 s (FEV1) (r=−0.79 and r=−0.78, respectively). Two distinct 3He-MRI patterns were highlighted: patients with abnormal FEV1 had significantly (p<0.001) larger, but fewer, contiguous defects than those with normal FEV1, who tended to have numerous small volume defects. These two MRI patterns were delineated by a VDP of ∼10%. At total lung capacity, when compared to EIVT, VDP and VHI reduced in all subjects (p<0.001), demonstrating improved ventilation distribution and regions of volume-reversible and nonreversible ventilation abnormalities.


2017 ◽  
Vol 16 ◽  
pp. S141
Author(s):  
J.B. Leonard ◽  
J.M. Gaffin ◽  
H.C.J. Lai

Author(s):  
Rikke Mulvad Sandvik ◽  
Per Magnus Gustafsson ◽  
Anders Lindblad ◽  
Paul David Robinson ◽  
Kim Gjerum Nielsen

Introduction: Recent studies indicate limited utility of nitrogen multiple breath washout (N2MBW) in infancy and advocate for using sulphur hexafluoride (SF6)MBW in this age group. Modern N2MBW systems, such as EXHALYZER D® (ECO MEDICS AG, Duernten, Switzerland), use O2 and CO2 sensors to calculate N2 concentrations (in principle: N2%=100-CO2%-O2%). High O2 and CO2 concentrations have now been shown to significantly suppress signal output from the other sensor, raising apparent N2 concentrations. We examined whether improved Exhalyzer D® N2-signal, accomplished after thorough examination of this CO2 and O2 interaction on gas sensors and its correction, leads to better agreement between N2MBW and SF6MBW in healthy infants and toddlers. Method: Within the same session 52 healthy children aged 1-36 months (mean 1.30 (SD 0.72) years) completed SF6MBW and N2MBW recordings (EXHALYZER D®, SPIROWARE® version 3.2.1) during supine quiet sleep. SF6 and N2 SPIROWARE® files were re-analyzed off-line with in-house software using identical algorithms as in SPIROWARE® with or without application of the new correction factors for N2MBW provided by ECO MEDICS AG. Results Applying the improved N2-signal significantly reduced mean (95% CI) differences between N2- and SF6MBW recorded functional residual capacity (FRC) and lung clearance index (LCI): for FRC, from 26.1 (21.0; 31.2) mL p<0.0001 to 1.18 (-2.3; 4.5) mL p=0.5, and for LCI, from 1.86 (1.68; 2.02) p<0.001 to 0.44 (0.33; 0.55) p<0.001. Conclusion: Correction of N2-signal, for CO2 and O2 interactions on gas sensors resulted in markedly closer agreement between N2MBW and SF6MBW outcomes in healthy infants and toddlers.


2020 ◽  
Vol 19 (6) ◽  
pp. 1027-1028 ◽  
Author(s):  
Marika N. Schmidt ◽  
Rikke M. Sandvik ◽  
Christian Voldby ◽  
Frederik F. Buchvald ◽  
Maria N. Jørgensen ◽  
...  

2020 ◽  
Vol 6 (4) ◽  
pp. 00408-2020
Author(s):  
Mirjam Stahl ◽  
Cornelia Joachim ◽  
Ines Kirsch ◽  
Tatjana Uselmann ◽  
Yin Yu ◽  
...  

BackgroundMultiple-breath washout (MBW)-derived lung clearance index (LCI) detects early cystic fibrosis (CF) lung disease. LCI was used as an end-point in single- and multicentre settings at highly experienced MBW centres in preschool children. However, multicentre feasibility of MBW in children aged 2–6 years, including centres naïve to this technique, has not been determined systematically.MethodsFollowing central training, 91 standardised nitrogen MBW investigations were performed in 74 awake preschool children (15 controls, 46 with CF, and 13 with other lung diseases), mean age 4.6±0.9 years at investigation, using a commercially available device across five centres in Germany (three experienced, two naïve to the performance in awake preschool children) with central data analysis. Each MBW investigation consisted of several measurements.ResultsOverall success rate of MBW investigations was 82.4% ranging from 70.6% to 94.1% across study sites. The number of measurements per investigation was significantly different between sites ranging from 3.7 to 6.2 (p<0.01), while the mean number of successful measurements per investigation was comparable with 2.1 (range, 1.9 to 2.5; p=0.46). In children with CF, the LCI was increased (median 8.2, range, 6.7–15.5) compared to controls (median 7.3, range 6.5–8.3; p<0.01), and comparable to children with other lung diseases (median 7.9, range, 6.6–13.9; p=0.95).ConclusionThis study demonstrates that multicentre MBW in awake preschool children is feasible, even in centres previously naïve, with central coordination to assure standardised training, quality control and supervision. Our results support the use of LCI as multicentre end-point in clinical trials in awake preschoolers with CF.


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