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The effect of inert gas choice on multiple breath washout in healthy infants: differences in lung function outcomes and breathing pattern

Artikel i vetenskaplig tidskrift
Författare Per M. Gustafsson
L. Bengtsson
Anders Lindblad
P. D. Robinson
Publicerad i Journal of Applied Physiology
Volym 123
Nummer/häfte 6
Sidor 1545-1554
ISSN 8750-7587
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Sidor 1545-1554
Språk en
Länkar https://doi.org/10.1152/japplphysio...
Ämnesord end-tidal CO2, functional residual capacity, inert gas washout, lung clearance index, breathing pattern, sulfur-hexafluoride, cystic-fibrosis, clearance index, children, age, appropriate, disease, cutoff, Physiology, Sport Sciences
Ämneskategorier Idrottsvetenskap, Fysiologi

Sammanfattning

The detrimental effects on breathing pattern during multiple breath inert gas washout (MBW) have been described with different inhaled gases [100% oxygen (O-2) and sulfur hexafluoride (SF6)] but detailed comparisons are lacking. N-2-and SF6-based tests were performed during spontaneous quiet sleep in 10 healthy infants aged 0.7-1.3 yr using identical hardware. Differences in breathing pattern pre and post 100% O-2 and 4% SF6 exposure were investigated, and the results obtained were compared [functional residual capacity (FRC) and lung clearance index (LCI)]. During 100% O-2 exposure. mean inspiratory flow ("respiratory drive") decreased transiently by mean (SD) 28 (9)% (P < 0.001), and end-tidal CO2 (carbon dioxide) increased by mean (SD) 0.3 (0.4)% units (P < 0.05) vs. air breathing prephase. During subsequent N-2 washin (i.e., recovery phase), the pattern of change reversed. No significant effect on breathing pattern was observed during SF6 testing. In vitro testing confirmed that technical artifacts did not explain these changes. Mean (SD) FRC and LCI in vivo were significantly higher with N-2 vs. SF6 washout: 216 (33) vs. 186 (22) ml (P < 0.001) and 8.25 (0.85) vs. 7.55 (0.57) turnovers (P < 0.021). Based on these results, SF6 based MBW is the preferred methodology for tests in this age range. NEW & NOTEWORTHY Inert gas choice for multiple breath inert gas washout (MBW) in infants has important consequences on both breathing pattern during test performance and the functional residual capacity and lung clearance index values obtained. Data suggest the detrimental effect of breathing pattern of 100% O-2 and movement of O-2 across the alveolar capillary membrane, with direct effects on MBW outcomes. SF6 MBW during infancy avoids this and can be further optimized by addressing the sources of technical artifact identified in this work.

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