AUTHOR=Postek Magdalena , Walicka-Serzysko Katarzyna , Milczewska Justyna , Sands Dorota 

TITLE=What Is Most Suitable for Children With Cystic Fibrosis—The Relationship Between Spirometry, Oscillometry, and Multiple Breath Nitrogen Washout

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.692949

DOI=10.3389/fped.2021.692949

ISSN=2296-2360

ABSTRACT=Introduction: In cystic fibrosis (CF) pathological lung changes begin early in life. The technological progress currently gives many diagnostic possibilities, however, pulmonary function testing in children remains problematic.
Objectives: Our study aimed to correlate the results of impulse oscillometry (IOS) with those of multiple breath nitrogen washout (MBNW) in our paediatric CF population. We also compared those parameters between the groups with and without spirometric features of obturation.
Methods: We collected 150 pulmonary function test sets including spirometry, IOS and MBNW carried out in CF patients aged 12.08±3.85 [6-18]. The study group was divided into two subgroups: IA (without obturation) and IB (with obturation). We also compared Sacin, Scond and oscillometry parameters of 20 patients aged 14-18 years who reached the appropriate tidal volume (VT) during MBNW.
Results: Statistical analysis showed a negative correlation between lung clearance index (LCI) and MEF25 z-score, MEF50 z-score (rSpearman=-0.61; rSpearman=-0.56;). Comparison of subgroups IA (n=102) and IB (n=48) indicated a statistically significant difference in LCI (p <0.001) and FEV1z-score (p <0.001), FEV1% pred (p <0.001), MEF25z-score (p <0.001) ), MEF50 z-score (p <0.001), MEF75 z-score (p <0.001), R5% pred (p <0.05) and R20% pred (p <0.01). LCI higher than 7.91 was found in 75.33% of the study group, in subgroup IB – 91.67% and IA – 67.6%, respectively. 
Conclusions: LCI derived from MBNW may be a better tool than IOS for assessing pulmonary function in CF patients, particularly those who cannot perform spirometry.