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Measuring exhaled nitric oxide in infants during tidal breathing: Methodological issues
Author(s) -
Franklin Peter J.,
Turner Stephen W.,
Mutch Raewyn C.,
Stick Stephen M.
Publication year - 2004
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.10382
Subject(s) - medicine , exhaled nitric oxide , wheeze , breathing , anesthesia , sedation , asthma , significant difference , expiration , nitric oxide , respiratory system , spirometry
Exhaled nitric oxide (FE NO ) may provide a tool for identifying infants at risk of developing allergic disease in childhood. In infants there is no standardized collection technique; however, the easiest method is to measure FE NO during tidal breathing. In this study we investigated various methodological issues for tidal breathing (TB) FE NO in infants. These included the effect of ambient NO, oral or nasal breathing, sedation, and tidal expiratory flow. Furthermore, we compared TB FE NO in 88 infants with and without wheeze. Ambient NO greater than 5 ppb significantly affected FE NO . There was no significant difference between NO levels measured during either oral or nasal breathing; however, there was a significant difference between levels collected from infants before and after sedation ( P < 0.001). Tidal breathing FE NO decreased with increasing tidal flows ( P < 0.001) and increased with age ( P = 0.002). There was no significant difference in mixed expired NO between healthy and wheezy children, but children with doctor‐diagnosed eczema had significantly raised levels ( P = 0.014). There seem to be important methodological limitations for measuring FE NO in infants during TB. Pediatr Pulmonol. 2004; 37:24–30. © 2004 Wiley‐Liss, Inc.