Multiple-breath washout testing may identify lung disease in symptomatic military personnel
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Use of multiple-breath washout testing was useful for detecting airway disease in symptomatic military personnel following deployment, researchers reported in Respiratory Medicine.
Multiple-breath washout testing is a noninvasive pulmonary function test that measures ventilation inhomogeneity using a lung clearance index, Lauren M. Zell-Baran, MPH, epidemiologist in the division of environmental and occupational health sciences at National Jewish Health, Denver, told Healio.
In their study, “[lung clearance index] scores were significantly more abnormal among those with deployment-related asthma and small airways disease compared to healthy controls, indicating that [multiple-breath washout] can be used as a diagnostic tool for deployment-related lung disease when other noninvasive tests such as spirometry are normal,” Zell-Baran said.
Researchers enrolled 103 healthy controls (mean age, 39.3 years; 50.5% men) and 71 symptomatic military deployers with asthma and/or distal lung disease (mean age, 42.4 years; 86% men) from March 2015 to March 2020. Participants completed a questionnaire, spirometry and multiple-breath washout testing.
Nine deployers had deployment-related asthma, 44 had deployment-related distal lung disease and 18 had both.
There was a significantly higher likelihood for deployers having an abnormal lung clearance index score indicating global ventilation inhomogeneity compared with controls (P < .0001), according to the study. After adjusting for sex, smoking status, smoking pack-years and BMI, lung clearance index scores were significantly more abnormal among deployers with deployment-related asthma and distal lung disease compared with controls.
The unadjusted variable Sacin measurement was higher among those with proximal and distal airways disease, the researchers reported. Overall, deployers who reported more frequent exposure to explosive blasts on deployment had significantly higher lung clearance index scores.
“Sensitive, reliable and noninvasive diagnostic tests are needed to characterize the lung diseases that can affect military personnel, who may be exposed during deployment to multiple inhalation hazards that have been linked to persistent and disabling respiratory symptoms,” Zell-Baran said. “Longitudinal follow-up with [multiple-breath washout] among symptomatic deployers will be helpful in understanding disease progression, reversibility or stability and should inform treatment of airways disease, including the use of inhaled bronchodilators and steroids.”
For more information:
Lauren M. Zell-Baran, MPH, can be reached at zellbaranl@njhealth.org.