Can we use portable nitric oxide analyzer in young children?

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Biomedical Engineering

Background:

• Asthma management can be enhanced by measuring fractional exhaled nitric oxide (FENO).
• Portable FENO analyzers offer potential for primary care settings.
• Previous studies validated devices in adults and older children, but not young children.

Purpose of the Study:

• To compare the accuracy and usability of a portable electrochemical device (NIOX MINO) with a stationary chemiluminescence device (NIOX) for FENO measurement in young children.
• To assess the feasibility of using NIOX MINO in primary care for pediatric asthma assessment.

Main Methods:

• Paired FENO measurements were conducted using stationary NIOX and portable NIOX MINO devices.
• Participants included children with asthmatic symptoms and age-matched healthy controls.
• Data analysis focused on success rates, reproducibility, correlation, and agreement between devices.

Main Results:

• The NIOX MINO device had a lower success rate (73%) compared to NIOX (93%) in children aged 3.9-8.5 years.
• Both devices demonstrated similar reproducibility and a strong correlation (r=0.97).
• Despite correlation, Bland-Altman analysis revealed wide limits of agreement, and both devices distinguished higher FENO in asthmatic children.

Conclusions:

• The NIOX MINO can serve as a screening tool for airway inflammation in children aged 4 and above.
• Its clinical utility is constrained by a lower measurement success rate and limited accuracy at low FENO levels.
• Further validation is needed to optimize the use of portable FENO devices in young pediatric populations.