The reproducibility and responsiveness of the lung clearance index in bronchiectasis
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Lung clearance index (LCI) is a potential clinical outcome marker in bronchiectasis. Its responsiveness to therapeutic intervention has not been determined. This study evaluates its responsiveness to a session of physiotherapy and intravenous antibiotic treatment of an exacerbation.
32 stable and 32 exacerbating bronchiectasis patients and 26 healthy controls were recruited. Patients had LCI and lung function performed before and after physiotherapy on two separate occasions in the stable patients and at the beginning and end of an intravenous antibiotic course in the exacerbating patients.
LCI was reproducible between visits in 25 stable patients, with an intraclass correlation of 0.978 (0.948, 0.991; p<0.001). There was no significant difference in LCI (mean±sd) between stable 11.91±3.39 and exacerbating patients 12.76±3.47, but LCI was significantly higher in both bronchiectasis groups compared with healthy controls (7.36±0.99) (p<0.001). Forced expiratory volume in 1 s improved after physiotherapy, as did alveolar volume after intravenous antibiotics, but LCI did not change significantly.
LCI is reproducible in stable bronchiectasis but unlike conventional lung function tests, is unresponsive to two short-term interventions and hence is unlikely to be a useful clinical tool for short-term acute assessment in these patients. Further evaluation is required to establish its role in milder disease and in the evaluation of long-term interventions.
32 stable and 32 exacerbating bronchiectasis patients and 26 healthy controls were recruited. Patients had LCI and lung function performed before and after physiotherapy on two separate occasions in the stable patients and at the beginning and end of an intravenous antibiotic course in the exacerbating patients.
LCI was reproducible between visits in 25 stable patients, with an intraclass correlation of 0.978 (0.948, 0.991; p<0.001). There was no significant difference in LCI (mean±sd) between stable 11.91±3.39 and exacerbating patients 12.76±3.47, but LCI was significantly higher in both bronchiectasis groups compared with healthy controls (7.36±0.99) (p<0.001). Forced expiratory volume in 1 s improved after physiotherapy, as did alveolar volume after intravenous antibiotics, but LCI did not change significantly.
LCI is reproducible in stable bronchiectasis but unlike conventional lung function tests, is unresponsive to two short-term interventions and hence is unlikely to be a useful clinical tool for short-term acute assessment in these patients. Further evaluation is required to establish its role in milder disease and in the evaluation of long-term interventions.
Date Issued
2015-11-30
Date Acceptance
2015-06-19
Citation
European Respiratory Journal, 2015, 46 (6), pp.1645-1653
ISSN
1399-3003
Publisher
European Respiratory Society: ERJ
Start Page
1645
End Page
1653
Journal / Book Title
European Respiratory Journal
Volume
46
Issue
6
Copyright Statement
© 2015 ERS. This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.
Sponsor
Welton Foundation
National Institute for Health Research
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000366948700018&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
N/A
BRU 6535
Subjects
Science & Technology
Life Sciences & Biomedicine
Respiratory System
CYSTIC FIBROSIS BRONCHIECTASIS
RANDOMIZED CONTROLLED-TRIAL
PRIMARY CILIARY DYSKINESIA
LONG-TERM
VENTILATION INHOMOGENEITY
PULMONARY EXACERBATION
HYPERTONIC SALINE
CHILDREN
DISEASE
MARKERS
Adult
Aged
Anti-Bacterial Agents
Bronchiectasis
Case-Control Studies
Disease Progression
Female
Humans
Lung Volume Measurements
Male
Middle Aged
Physical Therapy Modalities
Plethysmography, Whole Body
Prospective Studies
Pulmonary Diffusing Capacity
Reproducibility of Results
Respiratory Function Tests
Respiratory Therapy
Tomography, X-Ray Computed
11 Medical And Health Sciences
Publication Status
Published