Background: Multiple Breath washout (MBW) represents an important tool to detect early a possible pulmonary exacerbation especially in Cystic Fibrosis (CF) disease. Lung clearance index (LCI) is the most commonly reported multiple breath washout (MBW) index and in the last years was used as management measure for evaluation. Our aim was to analyze clinical utility of LCI index variability in pulmonary exacerbation in CF. Methods: A single-center study was conducted at CF Unit of Bambino Gesù Children’s Hospital among hospitalized > 3 years patients for pulmonary exacerbations and treated with antibiotic intravenous treatment for 14 days. MBW and spirometry were evaluated within 72 hours of admission to hospital and at the end of hospitalization. Descriptive analysis was conducted and correlations between quantitative variables were investigated. Results: Fifty-seven patients (M22/F35) with an average age 18.56 (± 8.54) years were enrolled. LCI 2.5 was significantly reduced at the end of antibiotic treatment in both pediatric and adult populations with an average improvement of -6% in 37/57 patients. 26/57 are stable in LCI values. A significant elevation of +7.30% was found for FEV1%. 4/57 (7.02 %) had a significant deterioration in LCI values at the end of IV antibiotic treatment. A positive good correlation among LCI 2.5 and Scond (rho= +0.615, p=0.000) and LCI 2.5 and Sacin (rho=+0.649, p=0.000) and a negative strong correlation between FEV1% and LCI 2.5 were found in post treatment period. A better increase of LCI 2.5 in < 18 years (-10.27% vs -4.57%) than adult was noticed. Conclusions: LCI may have a role in the routine clinical care of CF patients as a good tool to assess response to intravenous antibiotic therapy.

Introduction: Telemedicine and tele-monitoring represent an emerging-study area in several and chronic diseases. Tele-rehabilitation during Covid-19 disease became an essential tool to promote physical activity in total safety. Infact, for pwCF physical activity was fundamental not only for the respiratory program but also Aim: To evaluate the feasibility of home web-based program of home exercise training program in patients with cystic fibrosis during COVID-19 pandemic. Subjects and methods: 32 patients (12 M/ 20 F) age 20,52 (±9,3); FEV1 mean was 84,88% and Ph angle mean at T0 was 6,11 (sd 0,83). Results: Adherence average rate was 61,5 %. Satisfaction and utility scores were respectively 4.5 and 4.3(Likert Scale); about QoL the Body-domain had a statistically significant increase (pvalue <0.05). Conclusion: Web-based rehabilitation could be a good tool but more studies are needed to confirm optimal values of adherence. Although data are based on a small sample size and longer periods of treatment are requested to analyze especially the physiological answer about heart rate and lung volumes.