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Lung clearance index

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https://www.readbyqxmd.com/read/29020072/correcting-for-tissue-nitrogen-excretion-in-multiple-breath-washout-measurements
#1
Mica Kane, Jonathan H Rayment, Renee Jensen, Reginald McDonald, Sanja Stanojevic, Felix Ratjen
Nitrogen excreted from body tissues impacts the calculation of multiple breath nitrogen washout (MBWN2) outcomes. The aim of this study was to determine the effect of tissue N2 on MBWN2 outcomes in both healthy subjects and patients with CF and to assess whether it is possible to correct for tissue N2. The contribution of tissue N2 to MBWN2 outcomes was estimated by comparing MBWN2-derived functional residual capacity (FRCN2) to FRC measured by body plethysmography (FRCpleth) and by comparing MBW outcome measures derived from MBWN2 and sulfur hexafluoride MBW (MBWSF6)...
2017: PloS One
https://www.readbyqxmd.com/read/28982773/inter-test-reproducibility-of-the-lung-clearance-index-measured-by-multiple-breath-washout
#2
Esther Oude Engberink, Felix Ratjen, Stephanie D Davis, George Retsch-Bogart, Reshma Amin, Sanja Stanojevic
The lung clearance index (LCI) has strong intra-test repeatability; however, the inter-test reproducibility of the LCI is poorly defined.The aim of the present study was to define a physiologically meaningful change in LCI in preschool children, which discriminates changes associated with disease progression from biological variability.Repeated LCI measurements from a longitudinal cohort study of children with cystic fibrosis and age-matched controls were collected to define the inter-visit reproducibility of the LCI...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28950435/lung-clearance-index-lci-as-a-predictor-of-exercise-limitation-among-cf-patients
#3
Vasiliki Avramidou, Elpis Hatziagorou, Asterios Kampouras, Helge Hebestreit, Eleana Kourouki, Fotis Kirvassilis, John Tsanakas
INTRODUCTION: FEV1 is often considered the gold standard to monitor lung disease in cystic fibrosis (CF). Recently, there has been increasing interest in multiple breath washout (MBW) and cardiopulmonary exercise testing (CPET) as alternative or even more sensitive techniques. However, limited data exist on associations among the above methods. AIM: To evaluate the correlations between outcome measures of MBW and CPET and to examine if ventilation inhomogeneity can predict exercise intolerance...
September 26, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28934992/breast-cancer-metastases-to-the-thyroid-gland-an-uncommon-sentinel-for-diffuse-metastatic-disease-a-case-report-and-review-of-the-literature
#4
Agata M Plonczak, Aimee N DiMarco, Roberto Dina, Dorothy J Gujral, Fausto F Palazzo
BACKGROUND: Metastases to the thyroid are rare. The most common primary cancer to metastasize to the thyroid is renal cell carcinoma, followed by malignancies of the gastrointestinal tract, lungs, and skin, with breast cancer metastases to the thyroid being rare. Overall, the outcomes in malignancies that have metastasized to the thyroid are poor. There are no prospective studies addressing the role of surgery in metastatic disease of the thyroid. Isolated thyroidectomy has been proposed as a local disease control option to palliate and prevent the potential morbidity of tumor extension related to the airway...
September 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28886040/residual-volume-total-lung-capacity-ratio-confers-limited-additive-significance-to-lung-clearance-index-for-assessment-of-adults-with-bronchiectasis
#5
Wei-Jie Guan, Jing-Jing Yuan, Yan Huang, Hui-Min Li, Rong-Chang Chen, Nan-Shan Zhong
BACKGROUND: Mosaicism and hyperinflation are common pathophysiologic features of bronchiectasis. The magnitude of ventilation heterogeneity might have been affected by the degree of hyperinflation. Some studies have evaluated the discriminative performance of lung clearance index (LCI) in bronchiectasis patients, but the additive diagnostic value of hyperinflation metrics to LCI is unknown. OBJECTIVE: To compare LCI and the ratio of residual volume to total lung capacity (RV/TLC), along with the LCI normalized with RV/TLC, in terms of discriminative performance, correlation and concordance with clinical variables in adults with bronchiectasis...
2017: PloS One
https://www.readbyqxmd.com/read/28882651/in-cystic-fibrosis-lung-clearance-index-is-sensitive-to-detecting-abnormalities-appearing-at-exercise-in-children-with-normal-spirometry
#6
Riyadh Chelabi, Thibaud Soumagne, Alicia Guillien, Marc Puyraveau, Bruno Degano
Symptom-limited incremental cardiopulmonary exercise test was performed in school-age children with clinically stable cystic fibrosis (CF), all with normal spirometry. Physiological parameters were compared between patients with normal lung clearance index (LCI; n=6) and patients with elevated LCI (n=6). Dyspnoea ratings during exercise were similar in both groups. Although no patient had significant dynamic hyperinflation, end-expiratory lung volumes were higher throughout exercise in patients with elevated LCI...
September 4, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28871575/inert-gas-washout-background-and-application-in-various-lung-diseases
#7
Jakob Usemann, Sophie Yammine, Florian Singer, Philipp Latzin
Multiple breath inert gas washout (MBW) is a lung function technique to measure ventilation inhomogeneity. The technique was developed more than 60 years ago, but not much used for many decades. Technical improvements, easy protocols and higher sensitivity compared with standard lung function tests in some disease groups have led to a recent renaissance of MBW. The lung clearance index (LCI) is a common measure derived from MBW tests, and offers information on lung pathology complementary to that from conventional lung function tests such as spirometry...
September 5, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28866642/the-quantitative-link-of-lung-clearance-index-to-bronchial-segments-affected-by-bronchiectasis
#8
Sylvia Verbanck, Gregory G King, Wenxiao Zhou, Anne Miller, Cindy Thamrin, Daniel Schuermans, Bart Ilsen, Caroline W Ernst, Johan de Mey, Walter Vincken, Eef Vanderhelst
In adult patients with cystic fibrosis (CF), the lung clearance index (LCI) derived from the multiple breath washout relates to both acinar and conductive ventilation heterogeneity. The latter component predicts an association between LCI and the number of bronchial segments affected by bronchiectasis. Here, we experimentally demonstrated this association in patients with CF, and also examined an ancillary group of patients with non-CF bronchiectasis. We conclude that lung disease severity in terms of number of bronchial segments results in an associated LCI increase, likely constituting a portion of LCI that cannot be reversed by treatment in patients with CF lung disease...
September 2, 2017: Thorax
https://www.readbyqxmd.com/read/28862497/another-brick-in-the-wall-lung-clearance-index-and-lower-airways-pathology-in-preschool-cystic-fibrosis
#9
Jonathan H Rayment, Felix Ratjen
No abstract text is available yet for this article.
September 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28860172/the-effect-of-inert-gas-choice-on-multiple-breath-washout-in-healthy-infants-differences-in-lung-function-outcomes-and-breathing-pattern
#10
Per Magnus Gustafsson, Lovisa Bengtsson, Anders Lindblad, Paul David Robinson
Detrimental effects on breathing pattern during multiple breath inert gas washout (MBW) have been described with different inhaled gases (100% oxygen, O2, and sulfur hexafluoride, SF6) but detailed comparisons are lacking. N2 and SF6 based tests were performed during spontaneous quiet sleep in 10 healthy infants aged 0.7-1.3 years using identical hardware. Differences in breathing pattern pre and post 100% O2 and 4% SF6 exposure were investigated, and the results obtained compared (FRC and Lung Clearance Index, LCI)...
August 31, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28828532/pharmacokinetic-and-pharmacodynamics-of-intravenous-dexmedetomidine-in-morbidly-obese-patients-undergoing-laparoscopic-surgery
#11
Bo Xu, Dongxu Zhou, Li Ren, Steven Shulman, Xingan Zhang, Ming Xiong
BACKGROUND: This study was designed to investigate the pharmacokinetics and pharmacodynamics of dexmedetomidine in morbidly obese patients undergoing laparoscopic surgery. METHODS: Morbidly obese (body mass index ≥40 kg/m(2)) and normal weight patients scheduled for elective laparoscopic surgery were included (n = 8, each group). After baseline hemodynamic measurement, dexmedetomidine 1 μg/kg was administered over 10 min. General anesthesia was induced with propofol 1...
August 21, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28822728/variability-of-lung-clearance-index-in-clinically-stable-cystic-fibrosis-lung-disease-in-school-age-children
#12
Marcus Svedberg, Per M Gustafsson, Paul D Robinson, Monica Rosberg, Anders Lindblad
BACKGROUND: Data on long term variability of Lung Clearance Index (LCI) in Cystic Fibrosis (CF) is urgently needed to guide test result interpretation. Our aim was to evaluate LCI variability in clinically stable CF lung disease in school age children. METHODS: Paediatric patients, aged 6 to 17years, attending the outpatient CF clinic performed Multiple Breath Nitrogen Washout (Exhalyzer® D) and spirometry every third month over a period of one year. Clinical stability was assessed by the Cystic Fibrosis Clinical Score (CFCS) at each visit...
August 16, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28811149/three-center-feasibility-of-lung-clearance-index-in-infants-and-preschool-children-with-cystic-fibrosis-and-other-lung-diseases
#13
Mirjam Stahl, Simon Y Graeber, Cornelia Joachim, Sandra Barth, Isabell Ricklefs, Gesa Diekmann, Matthias V Kopp, Lutz Naehrlich, Marcus A Mall
BACKGROUND: Lung clearance index (LCI) detects early ventilation inhomogeneity and has been suggested as sensitive endpoint in multicenter intervention trials in infants and preschoolers with cystic fibrosis (CF). However, the feasibility of multicenter LCI in this age group has not been determined. We, therefore, investigated the feasibility of LCI in infants and preschoolers with and without CF in a three-center setting. METHODS: Following central training, standardized SF6-MBW measurements were performed in 73 sedated children (10 controls, 49 with CF and 14 with other lung diseases), mean age 2...
August 12, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28800247/reply-from-the-authors-of-comparison-of-lung-clearance-index-and-magnetic-resonance-imaging-for-assessment-of-lung-disease-in-children-with-cystic-fibrosis
#14
Mirjam Stahl, Mark O Wielpütz, Hans-Ulrich Kauczor, Marcus A Mall
No abstract text is available yet for this article.
August 11, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28798203/peripheral-ventilation-heterogeneity-determines-the-extent-of-bronchoconstriction-in-asthma
#15
Catherine E Farrow, Cheryl M Salome, Benjamin E Harris, Dale L Bailey, Norbert Berend, Gregory G King
In asthma, bronchoconstriction causes topographically heterogeneous airway narrowing, as measured by 3-dimensional ventilation imaging. Computation modelling suggests that peripheral airway dysfunction is a potential determinant of acute airway narrowing measured by imaging. We hypothesised that the development of low ventilation regions measured topographically by 3-dimensional imaging after bronchoconstriction is predicted by peripheral airway function. Fourteen (14) asthmatic subjects underwent ventilation Single Photon Emission Computed Tomography/CT (VSPECT/CT) before and after methacholine challenge...
August 10, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28761339/systemic-delivery-of-the-anticancer-agent-arenobufagin-using-polymeric-nanomicelles
#16
Xue Yuan, Qian Xie, Keyu Su, Zhijie Li, Dong Dong, Baojian Wu
Arenobufagin (ABG) is a major active component of toad venom, a traditional Chinese medicine used for cancer therapy. However, poor aqueous solubility limits its pharmacological studies in vivo due to administration difficulties. In this study, we aimed to develop a polymeric nanomicelle (PN) system to enhance the solubility of ABG for effective intravenous delivery. ABG-loaded PNs (ABG-PNs) were prepared with methoxy poly (ethylene glycol)-block-poly (d,l-lactic-co-glycolic acid) (mPEG-PLGA) using the solvent-diffusion technique...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28750677/inhaled-ap301-for-treatment-of-pulmonary-edema-in-mechanically-ventilated-patients-with-acute-respiratory-distress-syndrome-a-phase-iia-randomized-placebo-controlled-trial
#17
Katharina Krenn, Rudolf Lucas, Adrien Croizé, Stefan Boehme, Klaus Ulrich Klein, Robert Hermann, Klaus Markstaller, Roman Ullrich
BACKGROUND: High-permeability pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS) and is frequently accompanied by impaired alveolar fluid clearance (AFC). AP301 enhances AFC by activating epithelial sodium channels (ENaCs) on alveolar epithelial cells, and we investigated its effect on extravascular lung water index (EVLWI) in mechanically ventilated patients with ARDS. METHODS: Forty adult mechanically ventilated patients with ARDS were included in a randomized, double-blind, placebo-controlled trial for proof of concept...
July 27, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28719135/multiple-breath-washout-in-pediatric-patients-after-lung-transplantation
#18
S Nyilas, J Carlens, T Price, F Singer, C Müller, G Hansen, G Warnecke, P Latzin, N Schwerk
Forced expiratory volume in 1 second (FEV1 ) from spirometry is the most commonly used parameter to detect early allograft dysfunction after lung transplantation (LTx). There are concerns regarding its sensitivity. Nitrogen-multiple breath washout (N2 -MBW) is sensitive at detecting early global (lung clearance index [LCI]) and acinar (Sacin ) airway inhomogeneity. We investigated whether N2 -MBW indices indicate small airways pathology after LTx in children with stable spirometry. Thirty-seven children without bronchiolitis obliterans syndrome [BOS] at a median of 1...
July 18, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28708889/a-new-index-for-characterizing-micro-bead-motion-in-a-flow-induced-by-ciliary-beating-part-i-experimental-analysis
#19
Mathieu Bottier, Sylvain Blanchon, Gabriel Pelle, Emilie Bequignon, Daniel Isabey, André Coste, Estelle Escudier, James B Grotberg, Jean-François Papon, Marcel Filoche, Bruno Louis
Mucociliary clearance is one of the major lines of defense of the respiratory system. The mucus layer coating the pulmonary airways is moved along and out of the lung by the activity of motile cilia, thus expelling the particles trapped in it. Here we compare ex vivo measurements of a Newtonian flow induced by cilia beating (using micro-beads as tracers) and a mathematical model of this fluid flow, presented in greater detail in a second companion article. Samples of nasal epithelial cells placed in water are recorded by high-speed video-microscopy and ciliary beat pattern is inferred...
July 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28708866/a-new-index-for-characterizing-micro-bead-motion-in-a-flow-induced-by-ciliary-beating-part-ii-modeling
#20
Mathieu Bottier, Marta Peña Fernández, Gabriel Pelle, Daniel Isabey, Bruno Louis, James B Grotberg, Marcel Filoche
Mucociliary clearance is one of the major lines of defense of the human respiratory system. The mucus layer coating the airways is constantly moved along and out of the lung by the activity of motile cilia, expelling at the same time particles trapped in it. The efficiency of the cilia motion can experimentally be assessed by measuring the velocity of micro-beads traveling through the fluid surrounding the cilia. Here we present a mathematical model of the fluid flow and of the micro-beads motion. The coordinated movement of the ciliated edge is represented as a continuous envelope imposing a periodic moving velocity boundary condition on the surrounding fluid...
July 2017: PLoS Computational Biology
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