不同呼吸方案对儿童多次呼吸冲洗结果的影响。
Impact of different breathing protocols on multiple-breath washout outcomes in children.
作者信息
Yammine Sophie, Singer Florian, Gustafsson Per, Latzin Philipp
机构信息
Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital of Bern, Switzerland; University Children's Hospital of Basel UKBB, Switzerland.
Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital of Bern, Switzerland; University Children's Hospital of Zurich, Switzerland.
出版信息
J Cyst Fibros. 2014 Mar;13(2):190-7. doi: 10.1016/j.jcf.2013.08.010. Epub 2013 Sep 25.
BACKGROUND
To standardize multiple-breath washout (MBW) measurements, 1L tidal volume (VT) protocols were suggested. The effect on MBW derived ventilation inhomogeneity (VI) indices is unclear.
METHODS
We compared VI indices from free breathing MBW at baseline to 1L VT MBW performed in triplicates in 35 children (20 with CF). Mean (range) age was 12.8 (7.0-16.7) years, weight 42 (20-64) kg and height 151 (117-170) cm.
RESULTS
Baseline lung clearance index (LCI) increased from mean (SD) 11.0 (2.2) to 13.0 (2.6), p = 0.011, in CF and from 6.8 (0.5) to 7.7 (1.4), p = 0.004, in controls. Moment ratio and Scond similarly increased. While change in VI indices was heterogeneous in individuals, decrease in functional residual capacity was most strongly associated with LCI increase.
CONCLUSION
MBW protocols strongly influence measures of VI. The 1L VT MBW protocol leads to overestimation of VI and is not recommended in children.
背景
为规范多次呼吸洗脱（MBW）测量，有人提出了1升潮气量（VT）方案。其对MBW衍生的通气不均匀性（VI）指数的影响尚不清楚。
方法
我们比较了35名儿童（20名患有囊性纤维化）在基线时自由呼吸MBW与重复进行3次的1升VT MBW的VI指数。平均（范围）年龄为12.8（7.0 - 16.7）岁，体重42（20 - 64）千克，身高151（117 - 170）厘米。
结果
在囊性纤维化患者中，基线肺清除指数（LCI）从平均（标准差）11.0（2.2）增加到13.0（2.6），p = 0.011；在对照组中，从6.8（0.5）增加到7.7（1.4），p = 0.004。矩比和Scond同样增加。虽然个体的VI指数变化是异质性的，但功能残气量的减少与LCI增加的相关性最强。
结论
MBW方案对VI测量有很大影响。1升VT MBW方案会导致VI被高估，不建议在儿童中使用。
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