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

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@article{38f58886bbec4ee5800e38fc74ad0d51,
title = "Multiple Breath Washout for Diagnosing Asthma and Persistent Wheeze in Young Children",
abstract = "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.",
author = "Lambang Arianto and Henrik Hallas and Jakob Stokholm and Klaus B{\o}nnelykke and Hans Bisgaard and Chawes, {Bo L}",
year = "2019",
month = "5",
doi = "10.1513/AnnalsATS.201807-503OC",
language = "English",
volume = "16",
pages = "599--605",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
publisher = "American Thoracic Society",
number = "5",

}

RIS

TY - JOUR

T1 - Multiple Breath Washout for Diagnosing Asthma and Persistent Wheeze in Young Children

AU - Arianto, Lambang

AU - Hallas, Henrik

AU - Stokholm, Jakob

AU - Bønnelykke, Klaus

AU - Bisgaard, Hans

AU - Chawes, Bo L

PY - 2019/5

Y1 - 2019/5

N2 - 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.

AB - 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.

U2 - 10.1513/AnnalsATS.201807-503OC

DO - 10.1513/AnnalsATS.201807-503OC

M3 - Journal article

VL - 16

SP - 599

EP - 605

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 5

ER -

ID: 56439135