scholarly journals Lung Clearance Index in Children with Cystic Fibrosis during Pulmonary Exacerbation

2021 ◽  
Vol 10 (21) ◽  
pp. 4884
Author(s):  
Katarzyna Walicka-Serzysko ◽  
Magdalena Postek ◽  
Justyna Milczewska ◽  
Dorota Sands
Keyword(s):  
Cystic Fibrosis ◽  
Stable Condition ◽  
School Age Children ◽  
Pulmonary Exacerbation ◽  
Intravenous Antibiotic ◽  
Lung Clearance ◽  
Factors Affecting ◽  
Lung Clearance Index ◽  
Relative Change

(1) Background: Pulmonary exacerbation (PEx) is one of the main factors affecting the quality of life and life expectancy in patients with cystic fibrosis (CF). Our study aimed to evaluate the change in selected pulmonary function parameters, including lung clearance index (LCI), in patients with CF diagnosed with PEx. (2) Methods: We enrolled 40 children with CF aged 6–17. They performed spirometry and multiple breath nitrogen washout (MBNW) tests during a stable condition period at the beginning and the end of intravenous antibiotic treatment. (3) Results: LCI increased by 65% and FEV1 decreased by ≥10% in 40% of patients with CF during PEx. An absolute change in LCI between a stable condition period and PEx was 1.05 (±1.92) units, which corresponds to a relative change of 11.48% (±18.61) of the baseline. The relative decrease in FEV1 was −9.22% (±12.00) and the z-score was −0.67 (±1.13). After the PEx treatment, FEV1 increased by 11.05% (±9.04) on average, whereas LCI decreased by 1.21 ± 1.59 units on average, which represented 9.42% ± 11.40 compared to the value at the beginning of PEx. (4) Conclusions: The change in LCI captures a higher proportion of events with functional impairment than FEV1 in school-age children with CF.

scholarly journals Evaluation of Copeptin during Pulmonary Exacerbation in Cystic Fibrosis

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
I. Wojsyk-Banaszak ◽  
P. Sobkowiak ◽  
K. Jończyk-Potoczna ◽  
B. Narożna ◽  
W. Langwiński ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Clinical Laboratory ◽  
Complete Blood Count ◽  
Biological Fluids ◽  
Stable Condition ◽  
Inverse Correlation ◽  
Life Questionnaire ◽  
Pulmonary Exacerbation

Copeptin was found to be a stable biomarker of inflammation and stress response in cardiac, renal, metabolic, and respiratory conditions such as pneumonia. The aim of this study was to investigate the copeptin levels in biological fluids (serum and sputum supernatant) of cystic fibrosis pediatric patients during pulmonary exacerbation and remission and to investigate the possible influence of copeptin levels on disease severity and quality of life. Copeptin serum concentrations were measured in 28 pediatric cystic fibrosis (CF) patients: 13 in stable condition and 15 during pulmonary exacerbation. In 10 CF patients, copeptin was also measured in the sputum. In all the patients, we assessed complete blood count, BMI, sputum culture, lung function, and chest imaging (with Brasfield score). The severity of symptoms was assessed using the Shwachman-Kulczycki (SK) score, and the quality of life was assessed with the Cystic Fibrosis Quality of Life Questionnaire-Revised (CFQ-R). Copeptin concentrations in serum and sputum supernatant was measured using an ELISA kit. Statistical analysis was done in Statistica v.12. Serum and sputum copeptin levels were higher in CF patients during pulmonary exacerbation than in a stable period, but the differences were not significant (p=0.58 and p=0.13, respectively). Copeptin did not correlate significantly with any clinical, laboratory, or spirometry markers of exacerbation. There was, however, a significant inverse correlation between the serum copeptin level and symptoms severity (r=‐0.77, p=0.008) and radiological changes (r=‐0.5626, p=0.036) during pulmonary exacerbation in pediatric CF patients. Copeptin also inversely correlated with the quality of life domains in CF patients: vitality and eating habits, mostly loss of appetite (p=0.031 and p=0.016, respectively). Copeptin may be useful to identify patients with a higher risk of deterioration to improve their outcomes.

scholarly journals Lung clearance index during hospital admission in school-age children with cystic fibrosis

2014 ◽  
Vol 13 (6) ◽  
pp. 687-691 ◽  
Author(s):  
Liam Welsh ◽  
Christopher Nesci ◽  
Haily Tran ◽  
Marisol Tomai ◽  
Sarath Ranganathan
Keyword(s):  
Cystic Fibrosis ◽  
Hospital Admission ◽  
School Age Children ◽  
School Age ◽  
Lung Clearance ◽  
Lung Clearance Index

scholarly journals Lung clearance index in cystic fibrosis subjects treated for pulmonary exacerbations

2015 ◽  
Vol 46 (4) ◽  
pp. 1055-1064 ◽  
Author(s):  
Nicole Sonneveld ◽  
Sanja Stanojevic ◽  
Reshma Amin ◽  
Paul Aurora ◽  
Jane Davies ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Observational Studies ◽  
Forced Expiratory Volume ◽  
Response To Therapy ◽  
Lung Clearance ◽  
Clinical Events ◽  
Intravenous Antibiotics ◽  
Lung Clearance Index ◽  
Pulmonary Exacerbations ◽  
Relative Change

Pulmonary exacerbations are important clinical events for cystic fibrosis (CF) patients. Studies assessing the ability of the lung clearance index (LCI) to detect treatment response for pulmonary exacerbations have yielded heterogeneous results. Here, we conduct a retrospective analysis of pooled LCI data to assess treatment with intravenous antibiotics for pulmonary exacerbations and to understand factors explaining the heterogeneous response.A systematic literature search was performed to identify prospective observational studies. Factors predicting the relative change in LCI and spirometry were evaluated while adjusting for within-study clustering.Six previously reported studies and one unpublished study, which included 176 pulmonary exacerbations in both paediatric and adult patients, were included. Overall, LCI significantly decreased by 0.40 units (95% CI −0.60– −0.19, p=0.004) or 2.5% following treatment. The relative change in LCI was significantly correlated with the relative change in forced expiratory volume in 1 s (FEV1), but results were discordant in 42.5% of subjects (80 out of 188). Higher (worse) baseline LCI was associated with a greater improvement in LCI (slope: −0.9%, 95% CI −1.0– −0.4%).LCI response to therapy for pulmonary exacerbations is heterogeneous in CF patients; the overall effect size is small and results are often discordant with FEV1.

scholarly journals Variability of lung clearance index in clinically stable cystic fibrosis lung disease in school age children

2018 ◽  
Vol 17 (2) ◽  
pp. 236-241 ◽  
Author(s):  
Marcus Svedberg ◽  
Per M. Gustafsson ◽  
Paul D. Robinson ◽  
Monica Rosberg ◽  
Anders Lindblad
Keyword(s):  
Cystic Fibrosis ◽  
Lung Disease ◽  
Cystic Fibrosis Lung ◽  
School Age Children ◽  
School Age ◽  
Lung Clearance ◽  
Cystic Fibrosis Lung Disease ◽  
Lung Clearance Index

scholarly journals Lung clearance index to monitor treatment response in pulmonary exacerbations in preschool children with cystic fibrosis

Thorax ◽  
2018 ◽  
Vol 73 (5) ◽  
pp. 451-458 ◽  
Author(s):  
Jonathan H Rayment ◽  
Sanja Stanojevic ◽  
Stephanie D Davis ◽  
George Retsch-Bogart ◽  
Felix Ratjen
Keyword(s):  
Cystic Fibrosis ◽  
Preschool Children ◽  
Treatment Response ◽  
Antibiotic Treatment ◽  
Treatment Effect ◽  
Average Treatment Effect ◽  
Lung Clearance ◽  
Lung Clearance Index ◽  
Pulmonary Exacerbations ◽  
Relative Change

BackgroundAntibiotic treatment for pulmonary symptoms in preschool children with cystic fibrosis (CF) varies among clinicians. The lung clearance index (LCI) is sensitive to early CF lung disease, but its utility to monitor pulmonary exacerbations in young children has not been assessed.ObjectiveWe aim to (1) understand how LCI changes during lower respiratory tract symptoms relative to a recent clinically stable measurement, (2) determine whether LCI can identify antibiotic treatment response and (3) compare LCI changes to changes in spirometric indices.MethodsLCI and spirometry were measured at quarterly clinic visits over a 12-month period in preschool children with CF. Symptomatic visits were identified and classified as treated or untreated. Treatment response was estimated using propensity score matching methods.Results104 symptomatic visits were identified in 78 participants. LCI increased from baseline in both treated (mean relative change +23.8% (95% CI 16.2 to 31.4)) and untreated symptomatic visits (mean relative change +11.2% (95% CI 2.4 to 19.9)). A significant antibiotic treatment effect was observed when LCI was used as the outcome measure (average treatment effect −15.5% (95% CI −25.4 to −5.6)) but not for z-score FEV1.ConclusionLCI significantly deteriorated with pulmonary symptoms relative to baseline and improved with antibiotic treatment. These data suggest that LCI may have a role in the routine clinical care of preschool children with CF.

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