RT Journal Article
SR Electronic
T1 The interpretation of exhaled nitric oxide values in children with asthma depends on the degree of bronchoconstriction and the levels of asthma severity.
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.02889
DO 10.4187/respcare.02889
A1 Grzelewski Tomasz
A1 Majak Paweł
A1 Jerzyńska Joanna
A1 Stelmach Włodzimierz
A1 Stelmach Rafał
A1 Janas Anna
A1 Grzelewska Aleksandra
A1 Witkowski Konrad
A1 Makandjou-Ola Eusebio
A1 Stelmach Iwona
YR 2013
UL http://rc.rcjournal.com/content/early/2013/12/31/respcare.02889.abstract
AB Introduction: The clinical implications of FeNO measurements in childhood asthma are unclear. Aim: 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: It was a retrospective, cross-sectional study. We evaluated data from medical documentation of children with asthma with special attention to FeNO results, asthma severity, FEV1 (% predicted), and bronchial reversibility test (BRT). Results: Four hundred and five subjects (aged 6-18) completed the study. Median levels of FeNO increased linearly with subjects' age (p=0.025). We found a non-linear trend of pre-bronchodilator FEV1 across four quartiles of FeNO in episodic and mild asthma; we observed lower pre-bronchodilator FEV1 in children with higher FeNO, but only up to the FeNO value of 35.4 ppb; in children with FeNO value higher than 35.4 ppb, pre-bronchodilator FEV1 was increased. We found a linear increasing trend of change from baseline (after 400 mcg of salbutamol) in FEV1 across FeNO categories in children with moderate asthma. Conclusions: Our results suggest a need to measure FeNO before as well as after spirometry. Consequently, in children with asthma with bronchial obstruction we suggest assessing FeNO also after short-acting Beta2-agonists.