Lea Vilmann1, Frederik Buchvald1, Kent Green1, Kim Gjerum Nielsen2. 1. Danish PCD & ChILD Centre, CF Centre Copenhagen, Pediatric Pulmonary Service, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. 2. Danish PCD & ChILD Centre, CF Centre Copenhagen, Pediatric Pulmonary Service, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address: kgn@dadlnet.dk.
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 (N2MBW) in children. We compared their capacities for discriminating between children with asthma and healthy controls. METHODS: We measured FeNO and N2MBW-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 N2MBW. 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 N2MBW 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 N2MBW 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 Sacinvalues. CONCLUSION: The feasibility of measuring FeNO was highly age-dependent and not applicable in children under age 4. N2MBW was feasible in the majority of preschool children. Scond, but not FeNO, could discriminate between children with asthma and healthy controls.
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 (N2MBW) in children. We compared their capacities for discriminating between children with asthma and healthy controls. METHODS: We measured FeNO and N2MBW-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 N2MBW. 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 N2MBW 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 N2MBW 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 Sacinvalues. CONCLUSION: The feasibility of measuring FeNO was highly age-dependent and not applicable in children under age 4. N2MBW was feasible in the majority of preschool children. Scond, but not FeNO, could discriminate between children with asthma and healthy controls.
Authors: Paraskevi Xepapadaki; Paraskevi Korovessi; Claus Bachert; Susetta Finotto; Tuomas Jartti; John Lakoumentas; Marek L Kowalski; Anna Lewandowska-Polak; Heikki Lukkarinen; Nan Zhang; Theodor Zimmermann; Nikolaos G Papadopoulos Journal: J Clin Med Date: 2020-01-09 Impact factor: 4.241