Archives of Pediatrics (ISSN: 2575-825X)

research article

Satisfaction with Lung Clearance Index Testing as Compared to Spirometry Performed Before and After Hospitalization for Cystic Fibrosis Pulmonary Exacerbation

Danielle Goetz1*, M. Barbara Howard2, Changxing Ma1, Beth Cahill1, Michelle Westley2, Drucy Borowitz1, Daniel Sheehan1

1Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, USA

2John R. Oishei Children’s Hospital, Buffalo, NY, USA

*Corresponding author: Danielle Goetz, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, USA. Tel: +17168293955; Email: dgoetz@upa.chob.edu

Received Date: 29 December, 2017; Accepted Date: 12 January, 2018; Published Date: 23 January, 2018

Abstract

Introduction: Patients with Cystic Fibrosis (CF) have intermittent Pulmonary Exacerbations (PEx) with increased cough and decreased pulmonary function. Lung Clearance Index (LCI) measures ventilation inhomogeneity using inert gas or nitrogen washout. LCI is increased in CF compared to healthy subjects.  LCI decreases after treatment for CF PEx; whereas, forced expiratory volume in 1 second predicted (FEV1%) increases.  Relationships between objective measures (FEV1%, LCI by nitrogen washout) and qualitative measures (Patient Satisfaction) surrounding treatment for PEx have not been reported.

Materials and Methods: Subjects > age 7 years, admitted for treatment of PEx, were recruited. After informed consent/assent, spirometry and LCI (Nitrogen Washout) were performed at the beginning and end of treatment for PEx. A short questionnaire evaluated patient satisfaction with LCI and spirometry at both time points.

Results: Twenty-five patients with CF (9-25 years), performed spirometry and LCI before and after hospitalization for CF PEx. There was better satisfaction with LCI compared to PFT, (mean score 1.7 versus 2.8; LCI easier to perform) (p < 0.01).   There was an average decline in LCI of 1.5 units (±1.16, p <0.01); FEV1% increased by 10.1% (± 9.6, p< 0.01). There was a moderate inverse relationship between mean change in LCI and mean change in FEV1% predicted (r= - 0.43, p<0.01).

Conclusion: LCI was well tolerated by people with CF and was perceived to cause less cough and trouble breathing than spirometry. There was a moderate inverse correlation between LCI and FEV1%; both tests detect improvement in airways obstruction following treatment for CF.

Keywords: Cystic Fibrosis; Lung Clearance Index (LCI); Multiple Breath Washout (MBW); Patient Experience; Patient Satisfaction; Pulmonary Exacerbation


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