Early follow‐up of lung disease in infants with cystic fibrosis using the raised volume rapid thoracic compression technique and computed tomography during quiet breathing

• Published in: Pediatric pulmonology 2017-10, Vol.52 (10), p.1283-1290
• Main Authors: Gauthier, Rémi, Cabon, Yann, Giroux‐Metges, Marie Agnes, Du Boisbaudry, Cecile, Reix, Phillipe, Le Bourgeois, Muriel, Chiron, Raphael, Molinari, Nicolas, Saguintaah, Magali, Amsallem, Francis, Matecki, Stefan
• Format: Article
• Language: English
• Subjects: Airway management; Airway Obstruction - diagnosis; Airway Obstruction - diagnostic imaging; Airway Obstruction - physiopathology; Cystic fibrosis; Cystic Fibrosis - diagnosis; Cystic Fibrosis - diagnostic imaging; Cystic Fibrosis - physiopathology; Disease Progression; Female; Follow-Up Studies; Forced Expiratory Volume; Functional Residual Capacity; Human health and pathology; Humans; Infant; Infant, Newborn; Life Sciences; Longitudinal Studies; Lung - physiopathology; Lung diseases; Male; Medical screening; Neonatal Screening; Pediatrics; Pulmonology and respiratory tract; Respiration; Tomography; Tomography, X-Ray Computed
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.23786

Background Among the different techniques used to monitor lung disease progression in infants with CF diagnosed by Newborn screening (NBS), raised volume‐rapid thoracic compression (RVRTC) remains a promising tool. However, the need of sedation and positive pressure ventilation considerably limits its clinical use. We recently described a semi‐quantitative method to evaluate air trapping by chest tomography during quite breathing without sedation (CTqb score). This parameter is the radiological sign of airway obstruction and could be also used for lung disease follow‐up in infants with CF. However, its discriminative power compared with RVRTC and correlation with lung function parameters are not known. Objectives To compare the discriminative powers of the CTqb score and RVRTC parameters and to determine their correlation during the first year of life of infants with CF. Methods In this multicenter longitudinal study, infants with CF diagnosed by NBS underwent RVRTC and CT during quite breathing at 10 ± 4 weeks (n = 30) and then at 13 ± 1 months of age (n = 28). Results All RVRTC parameters and the CTqb score remained stable between evaluations. The CTqb score showed a higher discriminative power than forced expiratory volume in 0.5 s (FEV0.5; the main RVRTC parameter) at both visits (66% and 50% of abnormal values vs 30% and 28%, respectively). No correlation was found between CTqb score and, the different RVRTC parameters or the plethysmographic functional residual capacity, indicating that they evaluate different aspect of CF lung disease.