Leaks during multiple-breath washout: characterisation and influence on outcomes

ERJ Open Research
Nina LenherrPhilipp Latzin

Abstract

Nitrogen multiple-breath washout (N2MBW) is increasingly used in patients with cystic fibrosis. The current European Respiratory Society/American Thoracic Society consensus statement for MBW recommends the rejection of measurements with leaks. However, it is unclear whether this is necessary for all types of leaks. Here, our aim was to 1) model and 2) apply air leaks, and 3) to assess their influence on the primary MBW outcomes of lung clearance index and functional residual capacity. We investigated the influence of air leaks at various locations (pre-, intra- and post-capillary), sizes, durations and stages of the washout. Modelled leaks were applied to existing N2MBW data from 10 children by modifying breath tables. In addition, leaks were applied to the equipment during N2MBW measurements performed by one healthy adolescent. All modelled and applied leaks resulted in statistically significant but heterogeneous effects on lung clearance index and functional residual capacity. In all types of continuous inspiratory leaks exceeding a certain size, the end of the washout was not reached. For practical application, we illustrated six different "red flags",i.e.signs that enable easy identification of leaks during measurements. Ai...Continue Reading

References

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Citations

Apr 13, 2021·Expert Review of Respiratory Medicine·Pedro Mondéjar-LópezÒscar Asensio de la Cruz
Oct 16, 2020·Pediatric Pulmonology·Bettina S FrauchigerKathryn A Ramsey
Sep 3, 2021·Journal of Applied Physiology·Diana JansenLeo Heunks

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