{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:41:52Z","timestamp":1792111312687,"version":"4.4.0"},"reference-count":54,"publisher":"European Respiratory Society (ERS)","issue":"6","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/publications.ersnet.org\/user-licence"}],"funder":[{"DOI":"10.13039\/100008593","name":"European Respiratory Society","doi-asserted-by":"publisher","award":["TF-2020-01"],"award-info":[{"award-number":["TF-2020-01"]}],"id":[{"id":"10.13039\/100008593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2024,7,11]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Multiple breath washout is a lung function test based on tidal breathing that assesses lung volume and ventilation distribution. The aim of this analysis was to use the Global Lung Function Initiative methodology to develop all-age reference equations for the multiple breath washout indices lung clearance index (LCI) and functional residual capacity (FRC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Multiple breath washout data from healthy individuals were collated from sites. Data were re-analysed using the latest software versions. Reference equations were derived using the lambda-mu-sigma method using the generalised additive models of location shape and scale programme in R. The impact of equipment type, inert tracer gas and equipment dead space volume on the derived reference ranges were investigated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 23 sites (n=3647 test occasions) were submitted. Reference equations were derived from 1579 unique observations from participants between the ages of 2 and 81\u2005years. Equipment type, inert tracer gas and equipment dead space volume did not significantly affect the prediction equations for either LCI or FRC. Reference equations for LCI include age as the only predictor, whereas sex-specific reference equations for FRC included height and age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Global Lung Function Initiative reference equations for multiple breath washout variables provide a standard for reporting and interpretation of LCI and FRC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1183\/13993003.00524-2024","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T11:46:31Z","timestamp":1727351191000},"page":"2400524","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":42,"title":["Global Lung Function Initiative reference values for multiple breath washout indices"],"prefix":"10.1183","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4574-6917","authenticated-orcid":false,"given":"Kathryn A.","family":"Ramsey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Stanojevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Chavez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cole","family":"Bowerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham L.","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5239-1571","authenticated-orcid":false,"given":"Philipp","family":"Latzin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"O'Neill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7397-105X","authenticated-orcid":false,"given":"Paul D.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6941-8315","authenticated-orcid":false,"given":"Mirjam","family":"Stahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8245-1961","authenticated-orcid":false,"given":"Daniel J.","family":"Weiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelies M.","family":"Zwitserloot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-0058","authenticated-orcid":false,"given":"Alex","family":"Horsley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"2025082004350608000_64.6.2400524.1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01499-2021"},{"key":"2025082004350608000_64.6.2400524.2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02277-2018"},{"key":"2025082004350608000_64.6.2400524.3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00289-2020"},{"key":"2025082004350608000_64.6.2400524.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00161011"},{"key":"2025082004350608000_64.6.2400524.5","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00010-2017"},{"key":"2025082004350608000_64.6.2400524.6","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0016-2021"},{"key":"2025082004350608000_64.6.2400524.7","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02686-2020"},{"key":"2025082004350608000_64.6.2400524.8","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1164\/rccm.201507-1409OC","article-title":"Lung clearance index and structural lung disease on computed tomography in early cystic fibrosis","volume":"193","author":"Ramsey","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2025082004350608000_64.6.2400524.9","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00374-2016"},{"key":"2025082004350608000_64.6.2400524.10","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03112-2021"},{"key":"2025082004350608000_64.6.2400524.11","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201611-935OC"},{"key":"2025082004350608000_64.6.2400524.12","unstructured":"National Institute for Health and Care Excellence (NICE) . Cystic Fibrosis: Diagnosis and Management. NG78. 2017. www.nice.org.uk\/guidance\/ng78. Date last updated: 25 October 2017."},{"key":"2025082004350608000_64.6.2400524.13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12890-020-1101-6","article-title":"Clinical and lung function outcomes in a cohort of children with severe asthma","volume":"20","author":"de Gouveia Belinelo","year":"2020","journal-title":"BMC Pulm Med"},{"key":"2025082004350608000_64.6.2400524.14","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1513\/AnnalsATS.202006-584OC","article-title":"Multiple-breath washout outcome measures in adults with bronchiectasis","volume":"19","author":"O'Neill","year":"2022","journal-title":"Ann Am Thorac Soc"},{"key":"2025082004350608000_64.6.2400524.15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201310-1747OC"},{"key":"2025082004350608000_64.6.2400524.16","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-215504"},{"key":"2025082004350608000_64.6.2400524.17","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201712-967OC"},{"key":"2025082004350608000_64.6.2400524.18","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S164285"},{"key":"2025082004350608000_64.6.2400524.19","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.jtct.2022.02.002","article-title":"Multiple breath washout testing to identify pulmonary chronic graft versus host disease in children after hematopoietic stem cell transplantation","volume":"28","author":"Rayment","year":"2022","journal-title":"Transplant Cell Ther"},{"key":"2025082004350608000_64.6.2400524.20","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1097\/JOM.0000000000001058","article-title":"Utility of lung clearance index testing as a noninvasive marker of deployment-related lung disease","volume":"59","author":"Krefft","year":"2017","journal-title":"J Occup Environ Med"},{"key":"2025082004350608000_64.6.2400524.21","doi-asserted-by":"crossref","first-page":"106281","DOI":"10.1016\/j.rmed.2020.106281","article-title":"Multiple breath washout: a noninvasive tool for identifying lung disease in symptomatic military deployers","volume":"176","author":"Zell-Baran","year":"2021","journal-title":"Respir Med"},{"key":"2025082004350608000_64.6.2400524.22","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00164-2019"},{"key":"2025082004350608000_64.6.2400524.23","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/ajt.14432","article-title":"Multiple breath washout in pediatric patients after lung transplantation","volume":"18","author":"Nyilas","year":"2018","journal-title":"Am J Transplant"},{"key":"2025082004350608000_64.6.2400524.24","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00069712"},{"key":"2025082004350608000_64.6.2400524.25","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00289-2023"},{"key":"2025082004350608000_64.6.2400524.26","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.2147\/COPD.S143488","article-title":"ACTIVATE: the effect of aclidinium\/formoterol on hyperinflation, exercise capacity, and physical activity in patients with COPD","volume":"12","author":"Watz","year":"2017","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2025082004350608000_64.6.2400524.27","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1164\/rccm.201801-0074ST","article-title":"Preschool multiple-breath washout testing. An official American Thoracic Society technical statement","volume":"197","author":"Robinson","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2025082004350608000_64.6.2400524.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2019.11.006"},{"key":"2025082004350608000_64.6.2400524.29","doi-asserted-by":"crossref","first-page":"e0157523","DOI":"10.1371\/journal.pone.0157523","article-title":"A systematic approach to multiple breath nitrogen washout test quality","volume":"11","author":"Jensen","year":"2016","journal-title":"PLoS One"},{"key":"2025082004350608000_64.6.2400524.30","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/ppul.25119","article-title":"Multiple breath washout quality control in the clinical setting","volume":"56","author":"Frauchiger","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"2025082004350608000_64.6.2400524.31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073335"},{"key":"2025082004350608000_64.6.2400524.32","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1152\/japplphysiol.00511.2021","article-title":"Nitrogen-based lung clearance index: a valid physiological biomarker for the clinic","volume":"132","author":"Darquenne","year":"2022","journal-title":"J Appl Physiol"},{"key":"2025082004350608000_64.6.2400524.33","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1152\/japplphysiol.00338.2021","article-title":"Correction of sensor crosstalk error in Exhalyzer D multiple-breath washout device significantly impacts outcomes in children with cystic fibrosis","volume":"131","author":"Wyler","year":"2021","journal-title":"J Appl Physiol"},{"key":"2025082004350608000_64.6.2400524.34","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1152\/japplphysiol.00129.2021","article-title":"Improved agreement between N2 and SF6 multiple-breath washout in healthy infants and toddlers with improved EXHALYZER D sensor performance","volume":"131","author":"Sandvik","year":"2021","journal-title":"J Appl Physiol"},{"key":"2025082004350608000_64.6.2400524.35","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1152\/japplphysiol.00326.2018","article-title":"Difference between","volume":"125","author":"Guglani","year":"2018","journal-title":"J Appl Physiol"},{"key":"2025082004350608000_64.6.2400524.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2016.11.004"},{"key":"2025082004350608000_64.6.2400524.37","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00247-2019"},{"key":"2025082004350608000_64.6.2400524.38","doi-asserted-by":"crossref","first-page":"e0229300","DOI":"10.1371\/journal.pone.0229300","article-title":"Lung clearance index in healthy volunteers, measured using a novel portable system with a closed circuit wash-in","volume":"15","author":"Horsley","year":"2020","journal-title":"PLoS One"},{"key":"2025082004350608000_64.6.2400524.39","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00005512"},{"key":"2025082004350608000_64.6.2400524.40","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01302-2019"},{"key":"2025082004350608000_64.6.2400524.41","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02398-2021"},{"key":"2025082004350608000_64.6.2400524.42","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00695-2015"},{"key":"2025082004350608000_64.6.2400524.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2025082004350608000_64.6.2400524.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"2025082004350608000_64.6.2400524.45","doi-asserted-by":"crossref","first-page":"e208","DOI":"10.1016\/j.jcf.2022.02.013","article-title":"Impact of Spiroware re-analysis method on multiple-breath washout outcomes in children with cystic fibrosis","volume":"21","author":"Oestreich","year":"2022","journal-title":"J Cyst Fibros"},{"key":"2025082004350608000_64.6.2400524.46","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1002\/ppul.26430","article-title":"Reply to migration is not the perfect answer: optimized methodology to assess LCI agreement between corrected legacy multiple breath nitrogen washout data and that directly collected on updated software","volume":"58","author":"De Queiroz Andrade","year":"2023","journal-title":"Pediatr Pulmonol"},{"key":"2025082004350608000_64.6.2400524.47","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01519-2022"},{"key":"2025082004350608000_64.6.2400524.48","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00370-2023"},{"key":"2025082004350608000_64.6.2400524.49","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202302-0310ST"},{"key":"2025082004350608000_64.6.2400524.50","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12470"},{"key":"2025082004350608000_64.6.2400524.51","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.jcf.2013.08.010","article-title":"Impact of different breathing protocols on multiple-breath washout outcomes in children","volume":"13","author":"Yammine","year":"2014","journal-title":"J Cyst Fibros"},{"key":"2025082004350608000_64.6.2400524.52","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02765-2020"},{"key":"2025082004350608000_64.6.2400524.53","doi-asserted-by":"crossref","first-page":"00301-2020","DOI":"10.1183\/23120541.00301-2020","article-title":"Newly developed multiple-breath washout reference equations from the CHILD Cohort Study: implications of poorly fitting equations","volume":"7","author":"Lu","year":"2021","journal-title":"ERJ Open Res"},{"key":"2025082004350608000_64.6.2400524.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2018.12.019"}],"container-title":["European Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/13993003.00524-2024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T11:35:17Z","timestamp":1755689717000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/13993003.00524-2024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,26]]},"references-count":54,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,12,5]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1183\/13993003.00524-2024"],"URL":"https:\/\/doi.org\/10.1183\/13993003.00524-2024","relation":{},"ISSN":["0903-1936","1399-3003"],"issn-type":[{"value":"0903-1936","type":"print"},{"value":"1399-3003","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,26]]}}}