Year: 2023
Type: article
Study design: Observational Study
Abstract: Background The early life origins of chronic pulmonary diseases are thought to arise in peripheral small airways. Predictors of ventilation inhomogeneity, a proxy of peripheral airway function, are understudied in schoolchildren. Research Question Is the double-tracer gas single-breath washout (DTG-SBW) measurement feasible in a pediatric field study setting? What are the predictors of the DTG-SBW-derived ventilation inhomogeneity estimate in unselected schoolchildren? Study Design and Methods In this prospective cross-sectional field study, a mobile lung function testing unit visited participating schools in Switzerland. We applied DTG-SBW, fraction of exhaled nitric oxide (Feno), and spirometry measurements. The DTG-SBW is based on tidal inhalation of helium and sulfur-hexafluoride, and the phase III slope (SIII He-SF6 ) is derived. We assessed feasibility, repeatability, and associations of SIII He-SF6 with the potential predictors of anthropometrics, presence of wheeze (ie, parental report of one or more episode of wheeze in the prior year), Feno, FEV 1 , and FEV 1 /FVC. Results In 1,782 children, 5,223 DTG-SBW trials were obtained. The DTG-SBW was acceptable in 1,449 children (81.3%); the coefficient of variation was 39.8%. SIII He-SF6 was independently but weakly positively associated with age and BMI. In 276 children (21.2%), wheeze was reported. SIII He-SF6 was higher by 0.049 g.mol.L −1 in children with wheeze compared with those without and remained associated with wheeze after adjusting for age and BMI in a multivariable linear regression model. SIII He-SF6 was not associated with Feno, FEV 1 , and FEV 1 /FVC. Interpretation The DTG-SBW is feasible in a pediatric field study setting. On the population level, age, body composition, and wheeze are independent predictors of peripheral airway function in unselected schoolchildren. The variation of the DTG-SBW possibly constrains its current applicability on the individual level. Trial Registration ClinicalTrials.gov; No.: NCT03659838; URL: www.clinicaltrials.gov
Source: CHEST Journal
Authors: Anne-Christianne Kentgens, Johanna M. Kurz, Rebeca Mozun, Jakob Usemann, Eva S.L. Pedersen, Claudia E. Kuehni, Philipp Latzin, Alexander Moeller, Florian Singer, Alexander Moeller, Jakob Usemann, Philipp Latzin, Florian Singer, Johanna Kurz, Claudia E. Kuehni, Rebeca Mozun, Cristina Ardura-Garcia, Myrofora Goutaki, Eva S.L. Pedersen, Maria Christina Mallet, Kees de Hoogh
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,790
OpenAlex ID: W4386790852