الفهرس 
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Abstract
The increased prevalence of bronchiectasis among children and adolescents with its complications and comorbidities, together with its inflammatory origin pushes us to search for a non-invasive, easy, cheap, and rapid measure of inflammation such as EBC pH.
Activity of airway inflammation documented to change the pH of the airway lining fluid. Assessment of the expired breath condensate (EBC) constituents has proven to be useful and non invasive method for monitoring airway inflammation.
The aim of the study was to study EBC pH in Egyptian children with bronchiectasis. EBC Ph was studied in comparison to severity scores, and pulmonary function tests and whether it can be used as a non invasive measure of inflammation in children with bronchiectasis.
This study included 30 children with bronchiectasis attending the pediatric pulmonology unit, Ain Shams University hospitals. Age and sex matched 10 healthy children were selected as controls.
Children with bronchiectasis were classified into 2 groups;
Group1: comprised 12 patients with Non Cystic Fibrosis Bronchiectasis (NCFB).
Group2: comprised 18 patients with Cystic Fibrosis (CF) bronchiectasis.
All subjects included in this study were subjected to:
1- Full detailed history: with Special emphasis on respiratory symptoms, history of environmental exposure and history of exacerbations and complications.
2- Full thorough clinical General and local Examinations: With special emphasis on Anthropometric measures, Vital signs,Clubbing and Cyanosis toghether with local Chest examination.
3- Laboratory investigations including: CBC, CRP, Liver & Kidney functions, Electrolytes, faecal elastase, immunoglobulin assay, and Sweat Chloride tests were done.
4- Pulmonary function tests: To detect the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), mean expiratory flow between 25% and 75% of FVC (FEF25–75%), and FVC/FEV1 ratio using Spirolab III diagnostic colour spirometer.
5- EBC pH (exhaled breath condensate pH): was assessed.
Collection of EBC was done, using EcoScreen 2 device for exhaled breath condensate (EBC) collection at Pulmonary Adult Unit of internal medicine Ain Shams hospitals. EBC pH assessment was done using the five easy F20 pH meter manufactured by Mettler- Toledo GmbH device.
6- Assessment of critical illness and severity of disease by using:
- The SK score: Shwachman-Kulczycki score Used to monitor the severity of CF patients (Heba et al., 2022).
- CF RD‐Pro score: Cystic fibrosis at risk of disease progression score is used to identify the high‐risk CF patients liable for disease progression, (Marsteller et al., 2019).
Bronchiectasis Severity Index (BSI):
Evaluates the severity and prognosis of NCFB (Ellis et al., 2016).
Bronchiectasis Radiologically Indexed CT Score (BRICS):
Involves only 2 parameters which are; bronchial dilatation and number of bronchopulmonary segments with emphysema (Tiddens et al., 2020).
Modified Bhalla Score:
This score evaluates the severity of bronchiectasis in patients with CF (Diab-Cáceres et al., 2021).
The results in this study showed the following:
- Mean values FEV1, FEF25-75%, were significantly lower in the bronchiectatic group when compared to controls, while mean value of FVC was significantly lower in NCFB group.
- The mean values of EBC pH were significantly lower in bronchiecatic groups when compared to control being lower in CF group (Mean value 6.63) with cut off value = 7.3 in NCFB and 6.8 in CF patients.
- The mean values of EBC pH showed a significant positive correlation with pulmonary function tests FEV1, BSI and Bronchiectasis radiologically indexed CT score together with Weight, height and BMI z-score.
- The mean values of EBC pH showed significant positive correlation with CF PRO-RD (Cystic fibrosis risk of disease progression score) and modified Bhalla scores.
- The mean values of EBC pH were significantly related to severity of NCFB classified according to BSI, SK and BRICS scores, EBC pH values decreases being more acidic as severity increases.