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Ann Am Thorac Soc. 2015 Jun;12(6):932-9. doi: 10.1513/AnnalsATS.201501-021FR.

Multiple-Breath Washout as a Lung Function Test in Cystic Fibrosis. A Cystic Fibrosis Foundation Workshop Report.

Author information

1
1 Division of Respiratory Medicine, Department of Pediatrics, Physiology, and Experimental Medicine, The Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
2
2 Lucile Salter Packard Children's Hospital, Stanford University, Palo Alto, California.
3
3 Great Ormond Street Hospital, London, United Kingdom.
4
4 Royal Brompton Hospital, Imperial College London, London, United Kingdom.
5
5 Riley Hospital for Children at IU Health, Indiana University School of Medicine, Indianapolis, Indiana.
6
6 Telethon Kids Institute, University of Western Australia, Perth, Australia.
7
7 Seattle Children's Research Institute, University of Washington, Seattle, Washington.
8
8 University Children's Hospital Basel (UKBB), Basel, Switzerland.
9
9 Queen Silvia Children's Hospital, University of Gothenburg, Gothenburg, Sweden.
10
10 Washington University School of Medicine, St. Louis, Missouri.
11
11 Children's Hospital at Westmead, University of Sydney, Sydney, Australia.
12
12 Seattle Children's Hospital, University of Washington, Seattle, Washington.
13
13 University Children's Hospital Zurich, Zurich, Switzerland.
14
14 Children's Hospital of Iowa, University of Iowa, Iowa City, Iowa; and.
15
15 Arizona Health Science Center, University of Arizona, Tucson, Arizona.

Abstract

The lung clearance index (LCI) is a lung function parameter derived from the multiple-breath washout (MBW) test. Although first developed 60 years ago, the technique was not widely used for many years. Recent technological advances in equipment design have produced gains in popularity for this test among cystic fibrosis (CF) researchers and clinicians, particularly for testing preschool-aged children. LCI has been shown to be feasible and sensitive to early CF lung disease in patients of all ages from infancy to adulthood. A workshop was convened in January 2014 by the North American Cystic Fibrosis Foundation to determine the readiness of the LCI for use in multicenter clinical trials as well as clinical care. The workshop concluded that the MBW text is a valuable potential outcome measure for CF clinical trials in preschool-aged patients and in older patients with FEV1 in the normal range. However, gaps in knowledge about the choice of device, gas, and standardization across systems are key issues precluding its use as a clinical trial end point in infants. Based on the current evidence, there are insufficient data to support the use of LCI or MBW parameters in the routine clinical management of patients with CF.

KEYWORDS:

cystic fibrosis; lung clearance index; multiple-breath washout; pulmonary function tests

PMID:
26075554
PMCID:
PMC5466249
DOI:
10.1513/AnnalsATS.201501-021FR
[Indexed for MEDLINE]
Free PMC Article

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