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Multiple breath washout testing in adults with pulmonary disease and healthy controls – can fewer measurements eventually be more?

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BackgroundMultiple breath washout (MBW) became a valuable research tool assessing ventilation heterogeneity. However, routine clinical application still faces several challenges. Deriving MBW parameters from three technically acceptable measurements according to… Click to show full abstract

BackgroundMultiple breath washout (MBW) became a valuable research tool assessing ventilation heterogeneity. However, routine clinical application still faces several challenges. Deriving MBW parameters from three technically acceptable measurements according to current recommendations prolongs test times. We therefore aimed to evaluate reporting only duplicate measurements in healthy adults and pulmonary disease.MethodsOne hundred and fifty-three subjects prospectively underwent conventional lung function testing and closed-circuit SF6-MBW. Three technically acceptable MBW-measurements were obtained in 103 subjects.ResultsLung clearance index (LCI) differed significantly among 19 controls (7.4 ± 0.8), 19 patients with sarcoidosis (8.1 ± 1.2), 32 with bronchial asthma (9.2 ± 1.9) and 33 with COPD (10.8 ± 2.2, p < 0.001). Within-test repeatability was high (coefficient of variation between 2.5% in controls and 3.6% in COPD) and remained unchanged when only including the first two measurements. Likewise, LCI remained stable with mean absolute changes ranging from 0.9 ± 0.8% in controls to 1.5 ± 0.9% in COPD (p = 0.1). Mean test time reduction differed significantly between groups reaching 200 s in COPD (p = 0.01).ConclusionsDuplicate SF6-MBW-measurements are sufficient in adult patients with pulmonary disease and healthy controls. LCI values and intra-test repeatability are not affected reducing total test time statistically significant. Our findings have the potential to further facilitate application of MBW in research and clinical routine.Trial registrationNCT03176745, June 2, 2017 retrospectively registered.

Keywords: healthy controls; adults pulmonary; disease; disease healthy; breath washout; pulmonary disease

Journal Title: BMC Pulmonary Medicine
Year Published: 2017

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