EPS04.2 Infant lung function: First report of a novel infant multiple breath washout apparatus

Abstract

Objectives The value of lung clearance index (LCI) is well recognised in children and adults and has also been shown to be elevated in infants with CF. At present, there are considerable technical challenges in measuring LCI in infants. There is no simple method of assessing lung function in this population. The Innocor photoacoustic gas analyser measures very low concentrations of the inert tracer gas SF6. This has been developed into a novel mixed open–closed circuit system: expired gas is collected during washout to measure Functional Residual Capacity (FRC) and cumulative expired volume. This permits a low deadspace and ability to perform at rapid ventilation rates. Methods A prototype system was assessed using a lung model based on a mechanically driven 100 ml syringe and ventilation tank. The model delivered FRC's of 100–250 ml, with corresponding tidal volumes of 30–90 ml and respiratory rates of 20–40 min −1 . Improvements to hardware and washin protocol were made following initial testing. Results Following modification, overall mean error of FRC measurement was 0.04%. Actual mean FRC (ml) are shown in Table 1. Of 21 repeats, only 1 measurement was outside ±5% error range for FRC. Table 1Model FRC a (ml)Measured FRC (95% CI) (ml)Mean (SD) % error10299.2 (97.0–101.5)−1.76 (1.8)202203.3 (199.4–207.3)1.17 (2.34)252250.6 (247.4–253.8)−0.18 (1.63)aIncludes deadspace. Conclusion This system is capable of highly accurate measurement of FRC at volumes down to 100 ml in a realistic infant lung simulation. Accuracy is superior to previously described systems at higher FRC, and within the targets set by guidelines. In vivo testing is due to commence in 2015.