Abstract
IntroductionIn cystic fibrosis (CF), pathological lung changes begin early in life. The technological progress currently gives many diagnostic possibilities. However, pulmonary function testing in children remains problematic.ObjectivesOur study aimed to correlate the results of impulse oscillometry (IOS) with those of multiple breath nitrogen washout (MBNW) in our pediatric CF population. We also compared those parameters between the groups with and without spirometric features of obturation.MethodsWe collected 150 pulmonary function test sets, including spirometry, IOS, and MBNW in patients with CF aged 12.08 ± 3.85 years [6–18]. The study group was divided into two subgroups: IA (without obturation) and IB (with obturation). We also compared Sacin, Scond, and oscillometry parameters of 20 patients aged 14–18 years who reached the appropriate tidal volume (VT) during MBNW.ResultsStatistical analysis showed a negative correlation between lung clearance index (LCI) and spimoetric parameters. Comparison of subgroups IA (n = 102) and IB (n = 48) indicated a statistically significant difference in LCI (p < 0.001) and FEV1z-score (p < 0.001), FEV1% pred (p < 0.001), MEF25z-score (p < 0.001), MEF50 z-score (p < 0.001), MEF75 z-score (p < 0.001), R5% pred (p < 0.05), and R20% pred (p < 0.01). LCI higher than 7.91 was found in 75.33% of the study group, in subgroup IB—91.67%, and IA−67.6%.ConclusionsLCI derived from MBNW may be a better tool than IOS for assessing pulmonary function in patients with CF, particularly those who cannot perform spirometry.
Highlights
In cystic fibrosis (CF), pathological lung changes begin early in life
Statistical analysis showed a negative correlation between lung clearance index (LCI) and spimoetric parameters
LCI derived from multiple breath nitrogen washout (MBNW) may be a better tool than impulse oscillometry (IOS) for assessing pulmonary function in patients with CF, those who cannot perform spirometry
Summary
In cystic fibrosis (CF), pathological lung changes begin early in life. The technological progress currently gives many diagnostic possibilities. A gradual decrease in lung function is associated with some physiological factors such as airway obstruction and ventilation heterogeneity [1, 2] These changes should be able to be detected in lung function tests. Spirometry is considered to be the gold standard of lung function measurements in children older than 6 years and adults [3] This test is routinely used to assess lung function in children with CF. We tried to find a more suitable technique that would better complement the spirometry test for patients who are unable to perform it properly. This is a very important issue in routine clinical practice in CF centers
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