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Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function
Reshma Amin1, Padmaja Subbarao, Alisha Jabar
1Hospital for Sick Children, 555 University Avenue, Toronto Ontario M5G 1X8, Canada. reshma.amin@sickkids.ca
Thorax
|May 4, 2010
Summary
The lung clearance index (LCI) effectively detected treatment response to hypertonic saline in children with cystic fibrosis (CF) and mild lung disease. This measure of ventilation inhomogeneity shows promise for early intervention strategies.
Area of Science:
- Pulmonary Medicine
- Pediatric Respiratory Research
- Clinical Trials
Background:
- Sensitive outcome measures are needed for cystic fibrosis (CF) interventions in mild lung disease.
- Current spirometry may not detect early treatment effects.
- Ventilation inhomogeneity is a key aspect of CF lung disease.
Purpose of the Study:
- To evaluate the lung clearance index (LCI) as an outcome measure.
- To assess LCI's ability to detect treatment response to hypertonic saline (HS) in pediatric CF patients with normal spirometry.
- To compare HS efficacy against isotonic saline (IS) using LCI.
Main Methods:
- A randomized crossover trial involving 20 pediatric CF patients.
- Patients received 4 weeks of twice-daily HS and IS inhalation in a randomized sequence.
- A 4-week washout period separated the treatments.
- The primary endpoint was the change in LCI.
Main Results:
- Hypertonic saline (HS) significantly improved the LCI compared to isotonic saline (IS) (p=0.016).
- Improvements in LCI were observed after 4 weeks of HS inhalation.
- Spirometry and quality of life measures did not show statistically significant changes.
- Treatment order did not impact the observed treatment effect.
Conclusions:
- The lung clearance index (LCI) is a sensitive measure for detecting treatment effects in mild CF lung disease.
- LCI may be a valuable tool for assessing early intervention strategies in pediatric CF patients.
- Spirometry was less sensitive than LCI in detecting treatment response in this population.
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