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Ventilation inhomogeneity in infants with recurrent wheezing
Zihang Lu1,2, Rachel E Foong1,3, Krzysztof Kowalik1
1Division of Respiratory Medicine and Translational Medicine, Department of Pediatrics & Physiology, Hospital for Sick Children & University of Toronto, Toronto, Ontario, Canada.
Thorax
|June 17, 2018
Summary
Infants with recurrent wheezing show increased ventilation inhomogeneity, measured by the lung clearance index (LCI). This suggests early airway disease is present even when symptoms are not apparent.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Recurrent wheezing in infants is typically managed via clinical assessment.
- The lung clearance index (LCI) is a sensitive indicator of early airway disease in cystic fibrosis patients.
- The utility of LCI in infants with recurrent wheezing remains underexplored.
Purpose of the Study:
- To evaluate ventilation inhomogeneity using LCI in infants with recurrent wheezing compared to healthy controls.
Main Methods:
- A case-control study involving 37 infants with recurrent wheezing and 113 healthy infants.
- Functional assessments included multiple breath washout, forced expiratory flows, and body plethysmography during clinical stability.
Main Results:
- Infants with recurrent wheezing exhibited significantly higher LCI z-scores (0.84 units higher) than healthy infants (p<0.001).
- Nineteen percent of infants with recurrent wheezing had abnormal LCI values (above the upper limit of normal).
- Elevated exhaled nitric oxide, not symptoms, correlated with abnormal LCI in infants with recurrent wheeze (p=0.05).
Conclusions:
- Ventilation inhomogeneity is detectable in clinically stable infants experiencing recurrent wheezing.
- LCI may serve as a valuable tool for identifying early airway disease in this population.
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