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Lung clearance index is a sensitive, repeatable and practical measure of airways disease in adults with cystic fibrosis
  1. Alex Robert Horsley (alex.horsley{at}ed.ac.uk)
  1. Western General Hospital, Edinburgh, United Kingdom
    1. Per Magnus Gustafsson (per.gustafsson{at}vgregion.se)
    1. Queen Silvia Children's Hospital, Sweden
      1. Kenneth Macleod (kenny.macleod{at}ed.ac.uk)
      1. Royal Hospital for Sick Children, Edinburgh, United Kingdom
        1. Clare J Saunders (c.saunders{at}imperial.ac.uk)
        1. Imperial College, London, United Kingdom
          1. Andrew P Greening (a.greening{at}ed.ac.uk)
          1. Western General Hospital, Edinburgh, United Kingdom
            1. David Porteous (david.porteous{at}ed.ac.uk)
            1. Molecular Medicine Centre, Edinburgh University, United Kingdom
              1. Jane Davies (j.c.davies{at}imperial.ac.uk)
              1. Imperial College, London, United Kingdom
                1. Steve Cunningham (steve.cunningham{at}luht.scot.nhs.uk)
                1. Royal Hospital for Sick Children, Edinburgh, United Kingdom
                  1. Eric Alton (e.alton{at}ic.ac.uk)
                  1. Imperial College, London, United Kingdom
                    1. J Alastair Innes (a.innes{at}ed.ac.uk)
                    1. Western General Hospital, Edinburgh, United Kingdom

                      Abstract

                      Background: Lung clearance index (LCI) is a sensitive marker of early lung disease in children, but has not been assessed in adults. Measurement is hindered by the complexity of the equipment required. The aims of this study were to assess performance of a novel gas analyser (InnocorTM), and to use it as a clinical tool for the measurement of LCI in cystic fibrosis (CF).

                      Methods: LCI was measured in 48 healthy adults, 12 healthy school-age children, and 33 adults with CF, by performing an inert gas washout from 0.2% sulphur hexafluoride (SF6). SF6 signal:noise ratio and 10-90% rise time of Innocor were compared to a mass spectrometer used in similar studies in children.

                      Results: Compared to the mass spectrometer, Innocor has a superior signal:noise ratio, but a slower rise time (150 ms v 60 ms) which may limit its use in very young children. Mean (SD) LCI in healthy adults was significantly different from that in CF patients: 6.7 (0.4) v 13.1 (3.8), p<0.0001. Ten of the CF patients had FEV1≤80% predicted but only one had a normal LCI. LCI repeats were reproducible in all three groups of subjects (mean intra-visit coefficient of variation ranged from 3.6 to 5.4%).

                      Conclusions: Innocor can be adapted to measure LCI and affords a simpler alternative to a mass spectrometer. LCI is raised in CF adults with normal spirometry, and may prove to be a more sensitive marker of effects of therapy in this group.

                      • Cystic fibrosis
                      • Innocor
                      • Multiple breath washout
                      • Respiratory physiology

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                      • Web Only Data thx.2007.082628

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