Dinesh Raj1, Rakesh Lodha, Aparna Mukherjee, Tavpritesh Sethi, Anurag Agrawal, Sushil Kumar Kabra. 1. Division of Pediatric Pulmonology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029 and *Molecular Immunogenetics, CSIR-Institute of Genomics and Integrative Biology, New Delhi 110 007, India. Correspondence to: Dr Rakesh Lodha, Additional Professor, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India. rlodha1661@gmail.com.
Abstract
OBJECTIVE: To determine whether fractional exhaled nitric oxide (FENO) has a utility as a diagnostic or predictive maker in acute exacerbations of asthma in children. DESIGN: Analysis of data collected in a pediatric asthma cohort. SETTING: Pediatric Chest Clinic of a tertiary care hospital. METHODS: A cohort of children with asthma was followed up every 3 months in addition to any acute exacerbation visits. Pulmonary function tests (PFT) and FENO were obtained at all visits. We compared the FENO values during acute exacerbations with those at baseline and those during the follow up. RESULTS: 243 asthmatic children were enrolled from August 2009 to December 2011 [mean (SD) follow up - 434 (227) days]. FENO during acute exacerbations was not different from FENO during follow up; however, FENO was significantly higher than personal best FENO during follow up (P < 0.0001). FENO during acute exacerbation did not correlate with the severity of acute exacerbation (P=0.29). The receiver operating characteristics curve for FENO as a marker for acute exacerbation had an area under the curve of 0.59. Cut-off of 20 ppb had a poor sensitivity (44%) and specificity (68.7%) for acute exacerbation. CONCLUSIONS: FENO levels during acute exacerbation increase from their personal best levels. However, no particular cut off could be identified that could help in either diagnosing acute exacerbation or predicting its severity.
OBJECTIVE: To determine whether fractional exhaled nitric oxide (FENO) has a utility as a diagnostic or predictive maker in acute exacerbations of asthma in children. DESIGN: Analysis of data collected in a pediatric asthma cohort. SETTING: Pediatric Chest Clinic of a tertiary care hospital. METHODS: A cohort of children with asthma was followed up every 3 months in addition to any acute exacerbation visits. Pulmonary function tests (PFT) and FENO were obtained at all visits. We compared the FENO values during acute exacerbations with those at baseline and those during the follow up. RESULTS: 243 asthmatic children were enrolled from August 2009 to December 2011 [mean (SD) follow up - 434 (227) days]. FENO during acute exacerbations was not different from FENO during follow up; however, FENO was significantly higher than personal best FENO during follow up (P < 0.0001). FENO during acute exacerbation did not correlate with the severity of acute exacerbation (P=0.29). The receiver operating characteristics curve for FENO as a marker for acute exacerbation had an area under the curve of 0.59. Cut-off of 20 ppb had a poor sensitivity (44%) and specificity (68.7%) for acute exacerbation. CONCLUSIONS:FENO levels during acute exacerbation increase from their personal best levels. However, no particular cut off could be identified that could help in either diagnosing acute exacerbation or predicting its severity.
Authors: Eric Karlin; Tebeb Gebretsadik; R Stokes Peebles; Tina V Hartert; Emily W Langley; Donald H Arnold Journal: Ann Allergy Asthma Immunol Date: 2014-12-06 Impact factor: 6.347
Authors: Michelle M Cloutier; Alan P Baptist; Kathryn V Blake; Edward G Brooks; Tyra Bryant-Stephens; Emily DiMango; Anne E Dixon; Kurtis S Elward; Tina Hartert; Jerry A Krishnan; Robert F Lemanske; Daniel R Ouellette; Wilson D Pace; Michael Schatz; Neil S Skolnik; James W Stout; Stephen J Teach; Craig A Umscheid; Colin G Walsh Journal: J Allergy Clin Immunol Date: 2020-12 Impact factor: 10.793