Abstract
Background: Non cystic fibrosis, non primary ciliary dyskinesia bronchiectasis (nCFnPCD-BE) results in significant morbidity with few evidence-based treatments.
Objective: assessments are required to assess severity and evaluate treatment. Lung clearance index (LCI) measures ventilation inhomogeneity and is a sensitive test of disease in CF; its use in nCFnPCD-BE is unclear.
Methods: A systematic review of LCI in nCFnPCD-BE was performed using standard methodology (protocol registered on PROSPERO, University of York).
Results: Of 276 records identified, 12 articles, describing 519 adult and paediatric patients in cross-sectional studies were included, addressing several domains.
1: What is the utility of LCI in detecting disease and severity?
LCI detected disease in adults, differentiating bronchiectasis from controls (AUC 0.90 to 0.96) and mild from moderate/severe bronchiectasis on CT (AUC 0.73).
2: Does LCI correlate with spirometry and imaging?
LCI correlated with spirometry in adult (r = −0.37 to −0.61) and paediatric (r = −0.6) groups, signs of bronchiectasis on CT, and CT scoring systems (modified Reiff).
3: Does LCI relate to subjective scores of severity?
In adults, LCI correlated with St. George's Respiratory Questionnaire (r = 0.18) and Bronchiectasis Severity Index (r = 0.45).
4: Does LCI identify response to intervention?
LCI did not change in studies examining LCI pre-post intervention (adults treated for exacerbation and undergoing physiotherapy). Overall study quality was variable.
Conclusion: Contrary to data in CF, the review did not identify good quality studies defining the role of LCI in children with bronchiectasis. In adults, LCI was a sensitive measure of disease severity and correlated with clinical assessment tools.
Original language | English |
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Article number | 106937 |
Number of pages | 8 |
Journal | Respiratory Medicine |
Volume | 201 |
Early online date | 21 Jul 2022 |
DOIs | |
Publication status | Published - Sept 2022 |
Bibliographical note
Publisher Copyright:© 2022 Elsevier Ltd
Keywords
- Bronchiectasis
- Lung clearance index
- Outcome measure
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine