MOMENT ANALYSIS OF MULTIPLE BREATH NITROGEN WASHOUT IN CHILDREN

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Abstract
Clinical pulmonary function testing in children can be difficult as the young child may not be able to cooperate sufficiently to perform forced expiratory maneuvers. A test such as the multiple breath N2 washout (MBNW), which is measured during tidal breathing, would offer a distinct advantage. To assess the validity of the MBNW using moment analysis in older children who were capable of performing standard pulmonary function tests with which the MBNW could be compared, 16 healthy children, 11 with asthma and 14 with cystic fibrosis (CF), 7-16 yr of age, were studied; MBNW, spirometry, body plethysmographic lung volumes and maximal expiratory flow-volume curves were measured. Moment analysis was used to assess the MBNW and the results were expressed as the 2 moment ratios, M1/M0 and M2/M0. Multiple stepwise regressions for the control children showed sex to be the single best predictor of the moment ratio. Males had a significantly (P < 0.05) lower ratio than females. Patients with CF and asthma had significantly (P < 0.001) higher ratios than the control subjects. In these patients forced expiratory volume in 1 s was the best predictor of the moment ratios. Comparing spirometry with the moment ratios, concordant results for the detection of an abnormality were found in 15 of 25 patients. Maximal expiratory flow-volume curve detected an abnormality in 24 of 25 patients; MBNW was abnormal in 17. Moment analysis did separate normal from abnormal subjects and may prove to be useful in a younger age group.

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