Fractional exhaled nitric oxide and multiple breath nitrogen washout in preschool healthy and asthmatic children. (December 2017)

• Record Type: Journal Article
• Authors: Vilmann, Lea; Buchvald, Frederik; Green, Kent; Nielsen, Kim Gjerum
• Is Part Of: Respiratory medicine. Volume 133(2017)
• Page Start: 42
• Page End: 47
• Publication Date: 2017-12
• Subjects: Lung clearance index -- MBW -- FeNO -- Preschool -- Feasibility -- Children -- Asthma; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2017.10.027
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Introduction: Objectively assessing pulmonary disease is challenging in preschool children with asthma. We evaluated the feasibility of measuring fractional exhaled nitrogen oxide (FeNO) and multiple breath nitrogen washout (N2 MBW) in children. We compared their capacities for discriminating between children with asthma and healthy controls. Methods: We measured FeNO and N2 MBW-derived indices of lung clearance (LCI2.5 ) and conductive and acinar ventilation heterogeneity (Scond and Sacin ) in 65 preschool children; 35 with physician-diagnosed asthma and 30 healthy. FeNO was measured with a portable device (sampling time, 6 s). We employed data quality control guidelines on N2 MBW. Feasibility was evaluated in a maximum of 8 attempts for both methods. Atopic co-morbidity and first-degree disposition were evaluated with the ISAAC-questionnaire. Results: FeNO and N2 MBW testing were feasible in 45% and 91% of children, respectively. Feasibility was highly age-dependent. In children under 4 years old, FeNO was not feasible, but N2 MBW was 85% feasible. Children with asthma had significantly elevated Scond values (median; 95% CI) (0.024; 0.020; 0.029) compared to healthy controls (0.019; 0.016; 0.023), but similar FeNO, LCI2.5 and Sacin values. Conclusion: The feasibility of measuring FeNO was highly age-dependent and not applicable in children under age 4. N2 MBW was feasible in the majority of preschool children. Scond, but not FeNO, could discriminate between children with asthma and healthy controls. Highlights: N2 MBW was feasible in all age groups, whereas FeNO was not feasible below 4 years of age. Feasibility increased with age for both methods. Scond was significantly increased in the asthma group compared to healthy controls. Scond was significantly increased in non-atopic asthmatics compared to healthy controls. Atopic asthmatic children showed a non-significant higher FeNO compared to both non-atopic asthmatics and healthy controls.