Cargando…

Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis

BACKGROUND: Volumetric capnography (VCap) is a simpler alternative to multiple-breath washout (MBW) to detect ventilation inhomogeneity in patients with cystic fibrosis (CF). However, its diagnostic performance is influenced by breathing dynamics. We introduce two novel VCap indices, the capnographi...

Descripción completa

Detalles Bibliográficos
Autores principales: Fouzas, Sotirios, Kentgens, Anne-Christianne, Lagiou, Olga, Frauchiger, Bettina Sarah, Wyler, Florian, Theodorakopoulos, Ilias, Yammine, Sophie, Latzin, Philipp
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918935/
https://www.ncbi.nlm.nih.gov/pubmed/35295235
http://dx.doi.org/10.1183/23120541.00440-2021
_version_ 1784668837601345536
author Fouzas, Sotirios
Kentgens, Anne-Christianne
Lagiou, Olga
Frauchiger, Bettina Sarah
Wyler, Florian
Theodorakopoulos, Ilias
Yammine, Sophie
Latzin, Philipp
author_facet Fouzas, Sotirios
Kentgens, Anne-Christianne
Lagiou, Olga
Frauchiger, Bettina Sarah
Wyler, Florian
Theodorakopoulos, Ilias
Yammine, Sophie
Latzin, Philipp
author_sort Fouzas, Sotirios
collection PubMed
description BACKGROUND: Volumetric capnography (VCap) is a simpler alternative to multiple-breath washout (MBW) to detect ventilation inhomogeneity in patients with cystic fibrosis (CF). However, its diagnostic performance is influenced by breathing dynamics. We introduce two novel VCap indices, the capnographic inhomogeneity indices (CIIs), that may overcome this limitation and explore their diagnostic characteristics in a cohort of CF patients. METHODS: We analysed 320 N(2)-MBW trials from 50 CF patients and 65 controls (age 4–18 years) and calculated classical VCap indices, such as slope III (SIII) and the capnographic index (KPIv). We introduced novel CIIs based on a theoretical lung model and assessed their diagnostic performance compared to classical VCap indices and the lung clearance index (LCI). RESULTS: Both CIIs were significantly higher in CF patients compared with controls (mean±sd CII(1) 5.9±1.4% versus 5.1±1.0%, p=0.002; CII(2) 7.7±1.8% versus 6.8±1.4%, p=0.002) and presented strong correlation with LCI (CII(1) r(2)=0.47 and CII(2) r(2)=0.44 in CF patients). Classical VCap indices showed inferior discriminative ability (SIII 2.3±1.0%/L versus 1.9±0.7%/L, p=0.013; KPIv 3.9±1.3% versus 3.5±1.2%, p=0.071), while the correlation with LCI was weak (SIII r(2)=0.03; KPIv r(2)=0.08 in CF patients). CIIs showed lower intra-subject inter-trial variability, calculated as coefficient of variation for three and relative difference for two trials, than classical VCap indices, but higher than LCI (CII(1) 11.1±8.2% and CII(2) 11.0±8.0% versus SIII 16.3±13.5%; KPIv 15.9±12.8%; LCI 5.9%±4.2%). CONCLUSION: CIIs detect ventilation inhomogeneity better than classical VCap indices and correlate well with LCI. However, further studies on their diagnostic performance and clinical utility are required.
format Online
Article
Text
id pubmed-8918935
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher European Respiratory Society
record_format MEDLINE/PubMed
spelling pubmed-89189352022-03-15 Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis Fouzas, Sotirios Kentgens, Anne-Christianne Lagiou, Olga Frauchiger, Bettina Sarah Wyler, Florian Theodorakopoulos, Ilias Yammine, Sophie Latzin, Philipp ERJ Open Res Original Research Articles BACKGROUND: Volumetric capnography (VCap) is a simpler alternative to multiple-breath washout (MBW) to detect ventilation inhomogeneity in patients with cystic fibrosis (CF). However, its diagnostic performance is influenced by breathing dynamics. We introduce two novel VCap indices, the capnographic inhomogeneity indices (CIIs), that may overcome this limitation and explore their diagnostic characteristics in a cohort of CF patients. METHODS: We analysed 320 N(2)-MBW trials from 50 CF patients and 65 controls (age 4–18 years) and calculated classical VCap indices, such as slope III (SIII) and the capnographic index (KPIv). We introduced novel CIIs based on a theoretical lung model and assessed their diagnostic performance compared to classical VCap indices and the lung clearance index (LCI). RESULTS: Both CIIs were significantly higher in CF patients compared with controls (mean±sd CII(1) 5.9±1.4% versus 5.1±1.0%, p=0.002; CII(2) 7.7±1.8% versus 6.8±1.4%, p=0.002) and presented strong correlation with LCI (CII(1) r(2)=0.47 and CII(2) r(2)=0.44 in CF patients). Classical VCap indices showed inferior discriminative ability (SIII 2.3±1.0%/L versus 1.9±0.7%/L, p=0.013; KPIv 3.9±1.3% versus 3.5±1.2%, p=0.071), while the correlation with LCI was weak (SIII r(2)=0.03; KPIv r(2)=0.08 in CF patients). CIIs showed lower intra-subject inter-trial variability, calculated as coefficient of variation for three and relative difference for two trials, than classical VCap indices, but higher than LCI (CII(1) 11.1±8.2% and CII(2) 11.0±8.0% versus SIII 16.3±13.5%; KPIv 15.9±12.8%; LCI 5.9%±4.2%). CONCLUSION: CIIs detect ventilation inhomogeneity better than classical VCap indices and correlate well with LCI. However, further studies on their diagnostic performance and clinical utility are required. European Respiratory Society 2022-03-14 /pmc/articles/PMC8918935/ /pubmed/35295235 http://dx.doi.org/10.1183/23120541.00440-2021 Text en Copyright ©The authors 2022 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org)
spellingShingle Original Research Articles
Fouzas, Sotirios
Kentgens, Anne-Christianne
Lagiou, Olga
Frauchiger, Bettina Sarah
Wyler, Florian
Theodorakopoulos, Ilias
Yammine, Sophie
Latzin, Philipp
Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
title Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
title_full Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
title_fullStr Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
title_full_unstemmed Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
title_short Novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
title_sort novel volumetric capnography indices measure ventilation inhomogeneity in cystic fibrosis
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8918935/
https://www.ncbi.nlm.nih.gov/pubmed/35295235
http://dx.doi.org/10.1183/23120541.00440-2021
work_keys_str_mv AT fouzassotirios novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT kentgensannechristianne novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT lagiouolga novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT frauchigerbettinasarah novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT wylerflorian novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT theodorakopoulosilias novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT yamminesophie novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis
AT latzinphilipp novelvolumetriccapnographyindicesmeasureventilationinhomogeneityincysticfibrosis