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Slow and fast lung compartments in cystic fibrosis measured by nitrogen multiple-breath washout.
Gustafsson, P M; Robinson, P D; Gilljam, M; Lindblad, A; Houltz, B K.
Afiliación
  • Gustafsson PM; Department of Pediatrics, Central Hospital, Skövde, Sweden; The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; per.gustafsson@vgregion.se.
  • Robinson PD; Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia;
  • Gilljam M; The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Chest Medicine and Allergology, The Sahlgrenska University Hospital, Gothenburg, Sweden;
  • Lindblad A; The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Gothenburg, Sweden; and.
  • Houltz BK; The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Clinical Physiology, The Sahlgrenska University Hospital/East, Gothenburg, Sweden.
J Appl Physiol (1985) ; 117(7): 720-9, 2014 Oct 01.
Article en En | MEDLINE | ID: mdl-25038106
Imaging studies describe significant ventilation defects across a wide range of cystic fibrosis (CF) related lung disease severity. These are unfortunately poorly reflected by phase III slope analysis-derived Scond and Sacin from multiple-breath washout (MBW). Methodology extending previous two-lung compartment model-based analysis is presented describing size and function of fast- and slow-ventilating lung compartments from nitrogen (N2) MBW and correlation to obstructive lung disease severity. In 37 CF subjects (forced expiratory volume in 1 s [FEV1] mean [SD] 84.8 [19.9] % predicted; abnormal lung clearance index [LCI] in 36/37, range 7.28-18.9) and 74 matched healthy controls, volume and specific ventilation of both fast and slowly ventilated lung compartments were derived from N2-based MBW with commercial equipment. In healthy controls lung emptying was characterized by a large compartment constituting 75.6 (8.4)% of functional residual capacity (FRC) with a specific ventilation (regional alveolar tidal volume/regional lung volume) of 13.9 (3.7)% and a small compartment with high specific ventilation (48.4 [15.7]%). In CF the slowly ventilated lung compartment constituted 51.9(9.1)% of FRC, with low specific ventilation of 5.3 (2.4)%. Specific ventilation of the slowly ventilated lung compartment showed stronger correlation with LCI (r2 = 0.70, P < 0.001) vs. Sacin (r2 = 0.44, P < 0.001) or Scond (no significant correlation). Overventilation of the fast lung compartment was no longer seen in severe CF lung disease. Magnitude and function of under- and overventilated lung volumes can be derived from routine N2 MBW in CF. Reported values agree with previous modelling-derived estimates of impaired ventilation and offer improved correlation to disease severity, compared with SnIII analysis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrosis Quística / Pulmón Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: J Appl Physiol (1985) Asunto de la revista: FISIOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrosis Quística / Pulmón Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: J Appl Physiol (1985) Asunto de la revista: FISIOLOGIA Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos