TY - JOUR T1 - Ventilation inhomogeneity in infants with recurrent wheezing JF - Thorax JO - Thorax SP - 936 LP - 941 DO - 10.1136/thoraxjnl-2017-211351 VL - 73 IS - 10 AU - Zihang Lu AU - Rachel E Foong AU - Krzysztof Kowalik AU - Theo J Moraes AU - Ayanna Boyce AU - Aimee Dubeau AU - Susan Balkovec AU - Per Magnus Gustafsson AU - Allan B Becker AU - Piush J Mandhane AU - Stuart E Turvey AU - Wendy Lou AU - Felix Ratjen AU - Malcolm Sears AU - Padmaja Subbarao Y1 - 2018/10/01 UR - http://thorax.bmj.com/content/73/10/936.abstract N2 - Background The care of infants with recurrent wheezing relies largely on clinical assessment. The lung clearance index (LCI), a measure of ventilation inhomogeneity, is a sensitive marker of early airway disease in children with cystic fibrosis, but its utility has not been explored in infants with recurrent wheezing.Objective To assess ventilation inhomogeneity using LCI among infants with a history of recurrent wheezing compared with healthy controls.Methods This is a case–control study, including 37 infants with recurrent wheezing recruited from outpatient clinics, and 113 healthy infants from a longitudinal birth cohort, the Canadian Healthy Infant Longitudinal Development study. All infants, at a time of clinical stability, underwent functional assessment including multiple breath washout, forced expiratory flows and body plethysmography.Results LCI z-score values among infants with recurrent wheeze were 0.84 units (95% CI 0.41 to 1.26) higher than healthy infants (mean (95% CI): 0.26 (−0.11 to 0.63) vs −0.58 (−0.79 to 0.36), p<0.001)). Nineteen percent of recurrently wheezing infants had LCI values that were above the upper limit of normal (>1.64 z-scores). Elevated exhaled nitric oxide, but not symptoms, was associated with abnormal LCI values in infants with recurrent wheeze (p=0.05).Conclusions Ventilation inhomogeneity is present in clinically stable infants with recurrent wheezing. ER -