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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2022
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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 |
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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 |
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