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Lung Clearance Index in Children with Sickle Cell Disease
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  • Evans Machogu,
  • Monica Khurana,
  • Jennifer Kaericher,
  • Charles Clem,
  • James Slaven,
  • Joseph Hatch,
  • Stephanie Davis,
  • Stacey Peterson-Carmichael
Evans Machogu
Indiana University School of Medicine

Corresponding Author:emachogu@iupui.edu

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Monica Khurana
Indiana University School of Medicine
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Jennifer Kaericher
Indiana University School of Medicine
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Charles Clem
James Whitcomb Riley Hospital for Children
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James Slaven
Indiana University School of Medicine
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Joseph Hatch
University of North Carolina System
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Stephanie Davis
University of North Carolina at Chapel Hill School of Medicine
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Stacey Peterson-Carmichael
Wake Forest University
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Abstract

Introduction: The Lung Clearance Index (LCI) derived from the multiple-breath washout test (MBW), is both feasible and sensitive to early lung disease detection in young children with cystic fibrosis and asthma. The utility of LCI has not been studied in children with sickle cell disease (SCD). We hypothesized that children with SCD, with or without asthma or airway hyper reactivity (AHR), would have an elevated LCI compared to healthy controls. Methods: Children with SCD from a single center between the ages of 6-18 years were studied at baseline health and completed MBW, spirometry, plethysmography and blood draws for serum markers. Results were compared to healthy controls of similar race, age and gender. Results: Control subjects (n=35) had a significantly higher daytime oxygen saturation level, weight and body mass index (BMI) but not height compared to subjects with SCD (n=34). Total Lung Capacity(TLC) z-scores were significantly higher in the healthy controls compared to those with SCD (0.87 (1.13), 0.02 (1.27), p=0.005) while differences in Forced Expiratory Volume in 1 second (FEV1) z-scores approached significance (0.26 (0.97), -0.22 (1.09), p=0.055). There was no significant difference in LCI among the comparison groups (7.29 (0.72), 7.40 (0.69), p=0.514). Conclusion: LCI did not differentiate SCD from healthy controls in children between the ages of 6 and 18 years at baseline health. TLC may be an important pulmonary function measure to follow longitudinally in the pediatric SCD population.
06 Jul 2020Submitted to Pediatric Pulmonology
07 Jul 2020Submission Checks Completed
07 Jul 2020Assigned to Editor
08 Jul 2020Reviewer(s) Assigned
26 Jul 2020Review(s) Completed, Editorial Evaluation Pending
26 Jul 2020Editorial Decision: Revise Minor
08 Oct 20201st Revision Received
09 Oct 2020Submission Checks Completed
09 Oct 2020Assigned to Editor
09 Oct 2020Reviewer(s) Assigned
04 Nov 2020Review(s) Completed, Editorial Evaluation Pending
04 Nov 2020Editorial Decision: Accept
May 2021Published in Pediatric Pulmonology volume 56 issue 5 on pages 1165-1172. 10.1002/ppul.25186