Horsley, AR, Alrumuh, A, Bianco, B, Bayfield, K, Tomlinson, J, Jones, A, Maitra, A, Cunningham, S, Smith, J, Fullwood, C, Pandyan, A and Gilchrist, FJ (2020) Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in. PLoS One, 15 (2). ISSN 1932-6203

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Abstract

INTRODUCTION: Lung clearance index (LCI) is a sensitive measure of early lung disease, but adoption into clinical practice has been slow. Challenges include the time taken to perform each test. We recently described a closed-circuit inert gas wash-in method that reduces overall testing time by decreasing the time to equilibration. The aim of this study was to define a normative range of LCI in healthy adults and children derived using this method. We were also interested in the feasibility of using this system to measure LCI in a community setting.

METHODS: LCI was assessed in healthy volunteers at three hospital sites and in two local primary schools. Volunteers completed three washout repeats at a single visit using the closed circuit wash-in method (0.2% SF6 wash-in tracer gas to equilibrium, room air washout).

RESULTS: 160 adult and paediatric subjects successfully completed LCI assessment (95%) (100 in hospital, 60 in primary schools). Median coefficient of variation was 3.4% for LCI repeats and 4.3% for FRC. Mean (SD) LCI for the analysis cohort (n = 53, age 5-39 years) was 6.10 (0.42), making the upper limit of normal LCI 6.8. There was no relationship between LCI and multiple demographic variables. Median (interquartile range) total test time was 18.7 (16.0-22.5) minutes.

CONCLUSION: The closed circuit method of LCI measurement can be successfully and reproducibly measured in healthy volunteers, including in out-of-hospital settings. Normal range appears stable up to 39 years. With few subjects older than 40 years, further work is required to define the normal limits above this age.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Public Library of Science at https://doi.org/10.1371/journal.pone.0229300 - please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine and Health Sciences > Institute for Applied Clinical Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 13 Mar 2020 16:30
Last Modified: 11 Jun 2020 10:12
URI: https://eprints.keele.ac.uk/id/eprint/7793

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