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Closed circuit rebreathing to achieve inert gas wash-in for multiple breath wash-out

Horsley, Alex R.; O'Neill, Katherine; Downey, Damian G.; Elborn, J. Stuart; Bell, Nicholas J.; Smith, Jaclyn; Owers-Bradley, John

Authors

Alex R. Horsley

Katherine O'Neill

Damian G. Downey

J. Stuart Elborn

Nicholas J. Bell

Jaclyn Smith

John Owers-Bradley



Abstract

Multiple breath wash-out (MBW) testing requires prior wash-in of inert tracer gas. Wash-in efficiency can be enhanced by a rebreathing tracer in a closed circuit. Previous attempts to deploy this did not account for the impact of CO2 accumulation on patients and were unsuccessful. We hypothesised that an effective rebreathe wash-in could be delivered and it would not alter wash-out parameters.

Computer modelling was used to assess the impact of the rebreathe method on wash-in efficiency. Clinical testing of open and closed circuit wash-in–wash-out was performed in healthy controls and adult patients with cystic fibrosis (CF) using a circuit with an effective CO2 scrubber and a refined wash-in protocol.

Wash-in efficiency was enhanced by rebreathing. There was no difference in mean lung clearance index between the two wash-in methods for controls (6.5 versus 6.4; p=0.2, n=12) or patients with CF (10.9 versus 10.8; p=0.2, n=19). Test time was reduced by rebreathe wash-in (156 versus230 s for CF patients, p

Citation

Horsley, A. R., O'Neill, K., Downey, D. G., Elborn, J. S., Bell, N. J., Smith, J., & Owers-Bradley, J. (2016). Closed circuit rebreathing to achieve inert gas wash-in for multiple breath wash-out. ERJ Open Research, 2(1), https://doi.org/10.1183/23120541.00042-2015

Journal Article Type Article
Acceptance Date Nov 19, 2015
Publication Date Jan 22, 2016
Deposit Date Dec 21, 2016
Publicly Available Date Mar 29, 2024
Journal ERJ Open Research
Electronic ISSN 2312-0541
Publisher European Respiratory Society
Peer Reviewed Peer Reviewed
Volume 2
Issue 1
DOI https://doi.org/10.1183/23120541.00042-2015
Public URL https://nottingham-repository.worktribe.com/output/771886
Publisher URL http://openres.ersjournals.com/content/2/1/00042-2015

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