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[Utility of fractional exhaled nitric oxide in children with asthma]
Shu-Hua An1, Wen-Qiu Tian, Jin-Ying Li
1Department of Respiratory Medicine, Hebei Children's Hospital, Shijiazhuang 050031, China. mxyz2000@21cn.com.
Insights
Fractional exhaled nitric oxide (FeNO) levels differ across asthma stages in young children. Measuring FeNO aids in diagnosing asthma in this age group.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Biomarkers in Asthma
Context:
- Asthma diagnosis in young children (1-3 years) presents challenges.
- Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation.
- Understanding FeNO's utility across different asthma stages is crucial for management.
Purpose:
- To investigate the diagnostic value of FeNO in young children with asthma.
- To compare FeNO levels in children with acute exacerbation, chronic persistent asthma, and remission.
- To determine the optimal FeNO cut-off value for asthma diagnosis using ROC analysis.
Summary:
- FeNO levels were significantly higher in children with asthma compared to healthy controls.
- FeNO levels decreased progressively from acute exacerbation to chronic persistent asthma and remission stages.
- A FeNO cut-off of 22.75 ppb demonstrated high sensitivity (0.933) for asthma diagnosis in young children.
Impact:
- FeNO measurement is a valuable tool for diagnosing asthma in pre-school aged children.
- This study provides evidence supporting the use of FeNO in differentiating asthma severity.
- Findings can inform clinical practice guidelines for pediatric asthma management.
Objective:
To study the utility of fractional exhaled nitric oxide (FeNO) in young children at different stages of asthma.
Methods:
Fifty-eight children with newly diagnosed asthma (aged 1-3 years) at the acute exacerbation stage between April and June, 2014 were recruited. After 3 months' treatment, the children switched into the chronic persistent stage (n=34) or remission stage (n=24). Thirty aged-matched healthy children served as controls. FeNO levels and lung function were measured for all subjects. The best cut-off value of FeNO for the diagnosis of asthma was evaluated by receiver operating characteristic (ROC) curve.
Results:
The FeNO levels in children with asthma at various stages were higher than controls (P<0.05). The FeNO levels in the acute exacerbation stage were highest, followed by the chronic persistent stage (P<0.05). FeNO level was correlated to the stages of asthma (r=-0.382, P<0.001). The cut-off value of FeNO for the diagnosis of asthma was 22.75 ppb by ROC curve, with the sensitivity of 0.933 and the specificity of 0.388.
Conclusions:
The children with asthma at different stages have different FeNO levels. Measurement of FeNO is useful in the diagnosis of asthma in young children.
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