Division of Paediatric Pulmonology, University Children's Hospital Zurich, Zurich, Switzerland.
Division of Respiratory Medicine, Department of Pediatrics, University Children's Hospital of Bern, University of Bern, Bern, Switzerland.
Pediatr Pulmonol. 2018 Nov;53(11):1485-1491. doi: 10.1002/ppul.24149. Epub 2018 Aug 30.
Normalized phase III slope (Sn ) indices from multiple breath washout (MBW) estimate ventilation inhomogeneity. Alternate (*) protocols for Sn indices exist, however the utility of these outcomes in children with mild-to-moderate cystic fibrosis (CF) is unknown.
We measured nitrogen MBW and spirometry in 135 children (43 controls) aged 4-18 years. We assessed validity, practicability, and reliability of Sn protocols. Outcomes included the ability to detect abnormal lung function, test agreement, measurement duration, intra-test repeatability, and quality.
Lung clearance index (LCI) was abnormal in 80 (87%), Scond in 55 (60%), Scond* in 17 (19%), Sacin in 10 (11%), Sacin* in 11 (12%), and FEV in 28 (30%). Alternate protocols reduced measurement duration. Agreement of indices to detect abnormal lung function was poor. The quality of analysis and repeatability deteriorated with the alternate technique compared to standard.
In children with mild-to-moderate CF lung disease, alternate protocols seem practical but clinimetric properties of standard Sn protocols are preferable.
来自多次呼吸冲洗（MBW）的归一化 III 期斜率（Sn）指数估计通气不均匀性。存在替代（*）Sn 指数的方案，但是这些方案在轻度至中度囊性纤维化（CF）患儿中的应用尚不清楚。
我们测量了 135 名儿童（43 名对照者）的氮 MBW 和肺活量测定。我们评估了 Sn 方案的有效性、实用性和可靠性。结果包括检测异常肺功能的能力、测试一致性、测量时间、内测试重复性和质量。
80 例（87%）患儿的肺清除指数（LCI）异常，55 例（60%）的 Scond 异常，17 例（19%）的 Scond异常，10 例（11%）的 Sacin 异常，11 例（12%）的 Sacin异常，28 例（30%）的 FEV 异常。替代方案减少了测量时间。到检测异常肺功能的指数之间的一致性较差。与标准相比，替代技术的分析质量和重复性恶化。
在患有轻度至中度 CF 肺疾病的儿童中，替代方案似乎实用，但标准 Sn 方案的临床测量特性更可取。
