TY - JOUR
T1 - Preschool multiple-breath washout testing an official American thoracic society technical statement
AU - behalf of the ATS Assembly on Pediatrics
AU - Robinson, Paul D.
AU - Latzin, Philipp
AU - Ramsey, Kathryn A.
AU - Stanojevic, Sanja
AU - Aurora, Paul
AU - Davis, Stephanie D.
AU - Gappa, Monika
AU - Hall, Graham L.
AU - Horsley, Alex
AU - Jensen, Renee
AU - Lum, Sooky
AU - Milla, Carlos
AU - Nielsen, Kim G.
AU - Pittman, Jessica E.
AU - Rosenfeld, Margaret
AU - Singer, Florian
AU - Subbarao, Padmaja
AU - Gustafsson, Per M.
AU - Ratjen, Felix
N1 - Publisher Copyright:
Copyright © 2018 by the American Thoracic Society
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Background: Obstructive airway disease is nonuniformly distributed throughout the bronchial tree, although the extent to which this occurs can vary among conditions. The multiple-breath washout (MBW) test offers important insights into pediatric lung disease, not available through spirometry or resistance measurements. The European Respiratory Society/American Thoracic Society inert gas washout consensus statement led to the emergence of validated commercial equipment for the age group 6 years and above; specific recommendations for preschool children were beyond the scope of the document. Subsequently, the focus has shifted to MBW applications within preschool subjects (aged 2–6 yr), where a “window of opportunity” exists for early diagnosis of obstructive lung disease and intervention. Methods: This preschool-specific technical standards document was developed by an international group of experts, with expertise in both custom-built and commercial MBW equipment. A comprehensive review of published evidence was performed. Results: Recommendations were devised across areas that place specific age-related demands on MBW systems. Citing evidence where available in the literature, recommendations are made regarding procedures that should be used to achieve robust MBW results in the preschool age range. The present work also highlights the important unanswered questions that need to be addressed in future work. Conclusions: Consensus recommendations are outlined to direct interested groups of manufacturers, researchers, and clinicians in preschool device design, test performance, and data analysis for the MBW technique.
AB - Background: Obstructive airway disease is nonuniformly distributed throughout the bronchial tree, although the extent to which this occurs can vary among conditions. The multiple-breath washout (MBW) test offers important insights into pediatric lung disease, not available through spirometry or resistance measurements. The European Respiratory Society/American Thoracic Society inert gas washout consensus statement led to the emergence of validated commercial equipment for the age group 6 years and above; specific recommendations for preschool children were beyond the scope of the document. Subsequently, the focus has shifted to MBW applications within preschool subjects (aged 2–6 yr), where a “window of opportunity” exists for early diagnosis of obstructive lung disease and intervention. Methods: This preschool-specific technical standards document was developed by an international group of experts, with expertise in both custom-built and commercial MBW equipment. A comprehensive review of published evidence was performed. Results: Recommendations were devised across areas that place specific age-related demands on MBW systems. Citing evidence where available in the literature, recommendations are made regarding procedures that should be used to achieve robust MBW results in the preschool age range. The present work also highlights the important unanswered questions that need to be addressed in future work. Conclusions: Consensus recommendations are outlined to direct interested groups of manufacturers, researchers, and clinicians in preschool device design, test performance, and data analysis for the MBW technique.
KW - Cystic fibrosis
KW - Lung clearance index
KW - Multiple-breath washout
KW - Peripheral airway function
UR - http://www.scopus.com/inward/record.url?scp=85045398302&partnerID=8YFLogxK
U2 - 10.1164/rccm.201801-0074ST
DO - 10.1164/rccm.201801-0074ST
M3 - Article
C2 - 29493315
AN - SCOPUS:85045398302
SN - 1073-449X
VL - 197
SP - e1-e19
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 5
ER -