The interpretation of exhaled nitric oxide values in children with asthma depends on the degree of bronchoconstriction and the levels of asthma severity.

Abstract:

BACKGROUND:The clinical implications of fractional exhaled nitric oxide (F(ENO)) measurements in childhood asthma are unclear. We aimed to evaluate the relationship between the level of exhaled nitric oxide and pre-bronchodilator FEV1 and the change in FEV1 after bronchodilator in children with asthma. METHODS:This was a retrospective, cross-sectional study. We evaluated data from medical documentation of children with asthma with special attention to F(ENO) results, asthma severity, FEV1 (% predicted), and bronchial reversibility test. RESULTS:Four hundred and five subjects (age 6-18 y) completed the study. Median levels of F(ENO) increased linearly with subjects' age (P = .03). We found a nonlinear trend of pre-bronchodilator FEV1 across 4 quartiles of F(ENO) in episodic and mild asthma; we observed lower pre-bronchodilator FEV1 in children with higher F(ENO), but only up to the F(ENO) value of 35.4 ppb; in children with F(ENO) value > 35.4 ppb, pre-bronchodilator FEV1 was increased. We found a linear increasing trend of change from baseline (after 400 μg of salbutamol) in FEV1 across F(ENO) categories in children with moderate asthma. CONCLUSIONS:Our results suggest a need to measure F(ENO) before as well as after spirometry. Consequently, in children with asthma with bronchial obstruction, we suggest assessing F(ENO) after short-acting β2 agonists as well. (ClinicalTrials.gov registration NCT00815984.).

journal_name

Respir Care

journal_title

Respiratory care

authors

Grzelewski T,Majak P,Jerzyńska J,Stelmach W,Stelmach R,Janas A,Grzelewska A,Witkowski K,Makandjou-Ola E,Stelmach I

doi

10.4187/respcare.02889

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

1404-11

issue

9

eissn

0020-1324

issn

1943-3654

pii

respcare.02889

journal_volume

59

pub_type

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