{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T10:04:32Z","timestamp":1745834672996,"version":"3.37.3"},"reference-count":40,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hospital for Sick Children Foundation"},{"name":"Don and Debbie Morrison"},{"DOI":"10.13039\/501100002722","name":"AllerGen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002722","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The care of infants with recurrent wheezing relies largely on clinical assessment. The lung clearance index (LCI), a measure of ventilation inhomogeneity, is a sensitive marker of early airway disease in children with cystic fibrosis, but its utility has not been explored in infants with recurrent wheezing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess ventilation inhomogeneity using LCI among infants with a history of recurrent wheezing compared with healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a case\u2013control study, including 37 infants with recurrent wheezing recruited from outpatient clinics, and 113 healthy infants from a longitudinal birth cohort, the Canadian Healthy Infant Longitudinal Development study. All infants, at a time of clinical stability, underwent functional assessment including multiple breath washout, forced expiratory flows and body plethysmography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LCI z-score values among infants with recurrent wheeze were 0.84 units (95% CI 0.41 to 1.26) higher than healthy infants (mean (95%\u2009CI): 0.26 (\u22120.11 to 0.63) vs \u22120.58 (\u22120.79 to 0.36), p&lt;0.001)). Nineteen percent of recurrently wheezing infants had LCI values that were above the upper limit of normal (&gt;1.64\u2009z-scores). Elevated exhaled nitric oxide, but not symptoms, was associated with abnormal LCI values in infants with recurrent wheeze (p=0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ventilation inhomogeneity is present in clinically stable infants with recurrent wheezing.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thoraxjnl-2017-211351","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T16:23:56Z","timestamp":1529079836000},"page":"936-941","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Ventilation inhomogeneity in infants with recurrent wheezing"],"prefix":"10.1136","volume":"73","author":[{"given":"Zihang","family":"Lu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel E","family":"Foong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krzysztof","family":"Kowalik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theo J","family":"Moraes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayanna","family":"Boyce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimee","family":"Dubeau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Balkovec","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per Magnus","family":"Gustafsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan B","family":"Becker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piush J","family":"Mandhane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart E","family":"Turvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Lou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4057-6592","authenticated-orcid":false,"given":"Felix","family":"Ratjen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-4917","authenticated-orcid":false,"given":"Malcolm","family":"Sears","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0394-1933","authenticated-orcid":false,"given":"Padmaja","family":"Subbarao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,6,15]]},"reference":[{"key":"2020050723421292000_73.10.936.1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1056\/NEJM199501193320301","article-title":"Asthma and wheezing in the first six years of life","volume":"332","author":"Martinez","year":"1995","journal-title":"N Engl J Med Overseas Ed"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.2","DOI":"10.1056\/NEJMoa022363"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.3","DOI":"10.1056\/NEJMoa1513737"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.4","DOI":"10.1164\/rccm.201110-1922OC"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.5","DOI":"10.1164\/rccm.200504-525OC"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.6","DOI":"10.1016\/j.jaci.2011.02.002"},{"key":"2020050723421292000_73.10.936.7","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.jaci.2016.01.046","article-title":"Associations of wheezing phenotypes with late asthma outcomes in the avon longitudinal study of parents and children: a\u00a0population-based birth cohort","volume":"138","author":"Granell","year":"2016","journal-title":"J Allergy Clin Immunol"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.8","DOI":"10.1016\/j.jaci.2012.02.041"},{"doi-asserted-by":"publisher","key":"2020050723421292000_73.10.936.9","DOI":"10.1164\/rccm.200410-1404OC"},{"key":"2020050723421292000_73.10.936.10","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s40413-016-0123-2","article-title":"Manifesto on small airway involvement and management in asthma and chronic obstructive pulmonary disease: an Interasma (Global Asthma Association - 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