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Paediatric asthma
P77 Lung clearance index (LCI) in children with severe, therapy resistant asthma (STRA)
  1. S Irving1,
  2. A Bush2,
  3. C Bossley2,
  4. A Gupta2,
  5. S Saglani2
  1. 1Royal Brompton and Harefield NHS Foundation Trust, London, UK
  2. 2National Heart and Lung Institute, Imperial College, London, UK

Abstract

Introduction Spirometry is often normal in children with STRA, and is thus a poor outcome measure (1). Lung Clearance Index is a sensitive, non-effort dependent measure of distal airway gas mixing, which has been shown to be more sensitive than spirometry in Cystic Fibrosis (2). We hypothesised that LCI would be a better marker of steroid response in STRA than spirometry.

Patients and Methods 22 STRA children (Mean age 11.9 years, 15 male) had LCI and spirometry measured before and 4 weeks after intramuscular triamcinolone.

Results LCI was elevated in 18/22 prior to triamcinolone and 12/22 at the follow-up; in contrast FEV1 was only abnormal in 10/22 and 6/22 pretriamcinolone and posttriamcinolone respectively. Mean LCI fell from 7.86 to 7.25 (p<0.05) but there was no statistically significant decrease in FEV1 after triamcinolone.

Conclusion LCI is a better discriminant of STRA then FEV1, and is more responsive to steroid treatment. LCI may thus be a better outcome measure in STRA.

Abstract P77 Table 1

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