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Wyler F, Manogaran T, Monney N, Salem Y, Steinberg R, Kentgens AC, Jacobs C, Chaya S, Sena CRDS, Künstle N, Gorlanova O, Yammine S, Gray DM, Frey U, Oestreich MA, Latzin P. Optimized algorithm for speed-of-sound-based infant sulfur hexafluoride multiple-breath washout measurements. Pediatr Pulmonol 2024. [PMID: 39023392 DOI: 10.1002/ppul.27180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/29/2024] [Accepted: 07/10/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Major methodological issues with the existing algorithm (WBreath) used for the analysis of speed-of-sound-based infant sulfur hexafluoride (SF6) multiple-breath washout (MBW) measurements lead to implausible results and complicate the comparison between different age groups and centers. METHODS We developed OASIS-a novel algorithm to analyze speed-of-sound-based infant SF6 MBW measurements. This algorithm uses known context of the measurements to replace the dependence of WBreath on model input parameters. We validated the functional residual capacity (FRC) measurement accuracy of this new algorithm in vitro, and investigated its use in existing infant MBW data sets from different infant cohorts from Switzerland and South Africa. RESULTS In vitro, OASIS managed to outperform WBreath at FRC measurement accuracy, lowering mean (SD) absolute error from 5.1 (3.2) % to 2.1 (1.6) % across volumes relevant for the infant age range, in variable temperature, respiratory rate, tidal volume and ventilation inhomogeneity conditions. We showed that changes in the input parameters to WBreath had a major impact on MBW results, a methodological drawback which does not exist in the new algorithm. OASIS produced more plausible results than WBreath in longitudinal tracking of lung clearance index (LCI), provided improved measurement stability in LCI over time, and improved comparability between centers. DISCUSSION This new algorithm represents a meaningful advance in obtaining results from a legacy system of lung function measurement by allowing a single method to analyze measurements from different age groups and centers.
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Affiliation(s)
- Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thuvarakha Manogaran
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nathalie Monney
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ruth Steinberg
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Anne-Christianne Kentgens
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Carvern Jacobs
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Shaakira Chaya
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | | | - Noëmi Künstle
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Olga Gorlanova
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Diane M Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Urs Frey
- University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland
| | - Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Oestreich MA, Doswald I, Salem Y, Künstle N, Wyler F, Frauchiger BS, Kentgens AC, Latzin P, Yammine S. A computerized tool for the systematic visual quality assessment of infant multiple-breath washout measurements. Front Pediatr 2024; 12:1393291. [PMID: 38910962 PMCID: PMC11191423 DOI: 10.3389/fped.2024.1393291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/28/2024] [Indexed: 06/25/2024] Open
Abstract
Background Multiple-breath washout (MBW) is a sensitive method for assessing lung volumes and ventilation inhomogeneity in infants, but remains prone to artefacts (e.g., sighs). There is a lack of tools for systematic retrospective analysis of existing datasets, and unlike N2-MBW in older children, there are few specific quality control (QC) criteria for artefacts in infant SF6-MBW. Aim We aimed to develop a computer-based tool for systematic evaluation of visual QC criteria of SF6-MBW measurements and to investigate interrater agreement and effects on MBW outcomes among three independent examiners. Methods We developed a software package for visualization of raw Spiroware (Eco Medics AG, Switzerland) and signal processed WBreath (ndd Medizintechnik AG, Switzerland) SF6-MBW signal traces. Interrater agreement among three independent examiners (two experienced, one novice) who systematically reviewed 400 MBW trials for visual artefacts and the decision to accept/reject the washin and washout were assessed. Results Our tool visualizes MBW signals and provides the user with (i) display options (e.g., zoom), (ii) options for a systematic QC assessment [e.g., decision to accept or reject, identification of artefacts (leak, sigh, irregular breathing pattern, breath hold), and comments], and (iii) additional information (e.g., automatic identification of sighs). Reviewer agreement was good using pre-defined QC criteria (κ 0.637-0.725). Differences in the decision to accept/reject had no substantial effect on MBW outcomes. Conclusion Our visual quality control tool supports a systematic retrospective analysis of existing data sets. Based on predefined QC criteria, even inexperienced users can achieve comparable MBW results.
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Affiliation(s)
- Marc-Alexander Oestreich
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Isabelle Doswald
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Yasmin Salem
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Noëmi Künstle
- University Children’s Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Florian Wyler
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Bettina S. Frauchiger
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anne-Christianne Kentgens
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Oestreich MA, Hänni R, Wyler F, Kentgens AC, Yammine S, Obrist D, Latzin P, Ramsey KA. Comparison of functional residual capacity between updated infant SF 6 multiple-breath washout setups. Pediatr Pulmonol 2024; 59:518-520. [PMID: 38010843 DOI: 10.1002/ppul.26770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Marc-Alexander Oestreich
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Robin Hänni
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Florian Wyler
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Anne-Christianne Kentgens
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Sophie Yammine
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Dominik Obrist
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
| | - Kathryn A Ramsey
- Department of Paediatrics, Inselspital, Bern University Hospital, Division of Paediatric Respiratory Medicine and Allergology, University of Bern, Bern, Switzerland
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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Ardura-Garcia C, Abellan A, Cuevas-Ocaña S, Freitag N, Lam YT, Makrinioti H, Slaats M, Storti M, Williams EE, Dassios T, Duijts L, Ersu RH, Fustik S, Morty RE, Proesmans M, Schramm D, Saglani S, Moeller A, Pijnenburg MW. ERS International Congress 2021: highlights from the Paediatric Assembly. ERJ Open Res 2022; 8:00643-2021. [PMID: 35615416 PMCID: PMC9125040 DOI: 10.1183/23120541.00643-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/02/2022] [Indexed: 11/26/2022] Open
Abstract
In this review, Early Career Members of the European Respiratory Society (ERS) and the Chairs of the ERS Assembly 7: Paediatrics present the highlights in paediatric respiratory medicine from the ERS International Congress 2021. The eight scientific Groups of this Assembly cover respiratory physiology and sleep, asthma and allergy, cystic fibrosis (CF), respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology, bronchology, and lung and airway development. We here describe new developments in lung function testing and sleep-disordered breathing diagnosis, early life exposures affecting pulmonary function in children and effect of COVID-19 on sleep and lung function. In paediatric asthma, we present the important role of the exposome in asthma development, and how biologics can provide better outcomes. We discuss new methods to assess distal airways in children with CF, as some details remain blind when using the lung clearance index. Moreover, we summarise the new ERS guidelines for bronchiectasis management in children and adolescents. We present interventions to reduce morbidity and monitor pulmonary function in newborns at risk of bronchopulmonary dysplasia and long-term chronic respiratory morbidity of this disease. In respiratory epidemiology, we characterise primary ciliary dyskinesia, identify early life determinants of respiratory health and describe the effect of COVID-19 preventive measures on respiratory symptoms. Also, we describe the epidemiology of interstitial lung diseases, possible consequences of tracheomalacia and a classification of diffuse alveolar haemorrhage in children. Finally, we highlight that the characterisation of genes and pathways involved in the development of a disease is essential to identify new biomarkers and therapeutic targets.
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Affiliation(s)
| | - Alicia Abellan
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Sara Cuevas-Ocaña
- Nottingham Biodiscovery Institute, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nadine Freitag
- Dept of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Yin Ting Lam
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Heidi Makrinioti
- West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, London, UK
| | - Monique Slaats
- Dept of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Matteo Storti
- Dept of Chemical and Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Emma E. Williams
- Dept of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Theodore Dassios
- Dept of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Liesbeth Duijts
- Dept of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
- Division of Neonatology, Dept of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Refika H. Ersu
- Division of Respirology, University of Ottawa Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Stojka Fustik
- University Children's Hospital, Skopje, North Macedonia
| | - Rory E. Morty
- Dept of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
- Dept of Translational Pulmonology and the Translational Lung Research Center Heidelberg, University Hospital Heidelberg, Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Marijke Proesmans
- Division Woman and Child, Dept of Paediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Schramm
- Dept of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sejal Saglani
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Alexander Moeller
- Division of Paediatric Pulmonology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marielle W. Pijnenburg
- Dept of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
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