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Nitrogen multiple\u2010breath washout (N<jats:sub>2<\/jats:sub>\u2010MBW) is a lung function test that measures ventilation inhomogeneity, a biomarker of small airway disease. We assessed clinical properties of N<jats:sub>2<\/jats:sub>\u2010MBW in IPF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort pilot study, 25 IPF patients and 25 healthy controls were assessed at baseline and 10 patients at median 6.2 months later. Outcomes included the lung clearance index (LCI) from N<jats:sub>2<\/jats:sub>\u2010MBW, forced vital capacity (FVC) from spirometry, diffusion capacity of the lungs for carbon monoxide (DL<jats:sub>CO<\/jats:sub>), bronchiectasis score from computed tomography scans, the Gender\u2013Age\u2013Physiology (GAP score for IPF) stage and death or lung transplantation (LTx). Study end points were feasibility, repeatability, discriminative capacity and correlation with disease severity and structural lung damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were able to perform N<jats:sub>2<\/jats:sub>\u2010MBW. LCI was repeatable and reproducible. Median (interquartile range (IQR)) LCI in IPF was 11.6 (10.1\u201313.8) in IPF versus 7.3 (6.9\u20138.4) in controls (<jats:italic>P<\/jats:italic> &lt; 0.0001). LCI correlated with DL<jats:sub>CO<\/jats:sub> corrected for haemoglobin (corrDL<jats:sub>CO<\/jats:sub>; r = \u22120.49, <jats:italic>P<\/jats:italic> = 0.016), bronchiectasis score (r = 0.45, <jats:italic>P<\/jats:italic> = 0.024) and the GAP stage (r = 0.59, <jats:italic>P<\/jats:italic> = 0.002), but not with FVC. FVC was not related to bronchiectasis. During follow\u2010up, six patients died and one received LTx. LCI correlated with the latter compound outcome: hazard ratio (95% CI) was 2.43 (1.26; 4.69) per one LCI SD from the patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>N<jats:sub>2<\/jats:sub>\u2010MBW is a feasible, reliable and valid lung function test in IPF. LCI correlates with diffusion impairment, structural airway damage and clinical disease severity. LCI is a promising surveillance tool in IPF that may predict mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13294","type":"journal-article","created":{"date-parts":[[2018,3,24]],"date-time":"2018-03-24T23:25:51Z","timestamp":1521933951000},"page":"764-770","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Multiple breath washout: A new and promising lung function test for patients with idiopathic pulmonary fibrosis"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1840-3118","authenticated-orcid":false,"given":"Sylvia","family":"Nyilas","sequence":"first","affiliation":[{"name":"Division of Respiratory Medicine, Department of Pediatrics University Children's Hospital of Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Schreder","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Pediatrics University Children's Hospital of Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Poellinger","sequence":"additional","affiliation":[{"name":"Department of Interventional and Pediatric Radiology Bern University Hospital  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Kurt","family":"Geiser","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Latzin","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Pediatrics University Children's Hospital of Bern, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Funke","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,24]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"RaghuG CollardHR EganJJ MartinezFJ BehrJ BrownKK ColbyTV CordierJF FlahertyKR LaskyJAet al.;ATS\/ERS\/JRS\/ALAT Committee on Idiopathic Pulmonary Fibrosis. 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