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Downing B, Irving S, Bingham Y, Fleming L, Bush A, Saglani Set al., 2016, The feasibility of lung clearance index (LCI) in a clinical setting in pre-school children, European Respiratory Journal, Vol: 48, Pages: 1074-1080, ISSN: 1399-3003

Introduction: Lung function testing in pre-school children in the clinical setting ischallenging. Most cannot perform spirometry and many infant lung function tests requiresedation. Lung clearance index (LCI) derived from the multiple breath washout (MBW) testhas been shown to be sensitive to early disease changes but may be time consuming and soa shortened test (LCI0.5) may be more feasible in young children. We sought to establishfeasibility of MBW in unsedated pre-school children in a clinic setting, and hypothesised useof LCI0.5 would increase success rates.Methods: 116 pre-school children (28 healthy controls, 88 respiratory disease), median age4.0 (range 2-6) years performed MBW test unsedated in a clinic setting, using sulphurhexafluoride (SF6) as a tracer gas and an adapted photoacoustic gas analyser.Results: 81/116 (70%) completed LCI and 72% completed LCI0.5. Test success increasedsignificantly in patients over 3 years (0% <2.5yrs, 33% 2.5-3yrs, 70%>3yrs, p<0.0001). LCIwas elevated in those with respiratory disease compared with healthy controls.Conclusions: MBW is feasible in a clinic setting in unsedated pre-schoolers, particularly inthose over 3 years old, and LCI is raised in those with respiratory disease. Use of LCI0.5 didnot increase success rate in pre-schoolers.

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