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Multiple Breath Washout for Diagnosing Asthma and Persistent Wheeze in Young Children

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RATIONALE: There is an unmet need for sensitive lung function tests for young children to aid in the diagnosis of asthma and wheezy disorders. We hypothesized that multiple breath washout (MBW) could be a valuable tool for such purpose.

OBJECTIVE: To compare the ability of MBW lung clearance index (LCI) with traditional lung function measurements to discriminate between well-controlled preschool children with asthma/persistent wheeze and healthy children.

METHODS: We investigated 646 children from the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) mother-child cohort, who completed MBW testing with nitrogen, spirometry and plethysmography before age 6. Asthma/persistent wheeze was prospectively diagnosed according to a validated symptom-based algorithm at the COPSAC clinic. Student's t-tests and receiver operating characteristic (ROC) curves were applied to analyze the discriminative ability of the lung function indices.

RESULTS: 144 (22.3%) children were diagnosed with asthma/persistent wheeze during their first 6 years of life. LCI from MBW was not significantly different in children with vs. without asthma/persistent wheeze: mean (SD), 6.96 (1.14) vs. 6.95 (0.93), mean difference [95% CI], 0.02 [-0.18-0.22], p=0.86, area under the curve (AUC) 0.48, whereas significant differences were observed for sRaw from plethysmography (1.21kPa/s (0.31) vs. 1.14kPa/s (0.25), +0.07kPa/s [0.02-0.13], p<0.01, AUC=0.56) and spirometry FEV1 %-predicted (99.4% (12.0) vs. 102.6% (12.5), -3.2% [-5.6--0.9], p<0.01, AUC=0.56) and FEF25-75% (1.55L/s (0.44) vs. 1.68L/s (0.46), -0.14L/s [-0.22--0.05], p<0.01, AUC=0.58). FEV1 (L/s) and FEV1/FVC-ratio were not significantly different (p>0.4).

CONCLUSION: MBW, spirometry and plethysmography are not sensitive tools for diagnosing mild asthmatic disease in young children.

Original languageEnglish
JournalAnnals of the American Thoracic Society
Volume16
Issue number5
Pages (from-to)599-605
Number of pages7
ISSN2325-6621
DOIs
Publication statusPublished - May 2019

ID: 56439135