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Eucapnic voluntary hyperventilation test decreases exhaled nitric oxide level in children
Janne Burman1, Pekka Malmberg1, Varpu Elenius2
1Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Clinical Physiology and Functional Imaging
|October 27, 2020
Summary
The eucapnic voluntary hyperventilation (EVH) test can decrease exhaled nitric oxide (FeNO) levels in children. Measuring FeNO before the EVH test is recommended to ensure accurate asthma diagnosis.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Allergy and Immunology
Background:
- Exhaled nitric oxide (FeNO) and eucapnic voluntary hyperventilation (EVH) tests are established diagnostic tools for asthma.
- Limited data exists on how hyperventilation impacts FeNO levels.
Purpose of the Study:
- To investigate the effect of EVH tests on FeNO levels in children aged 10-16 years.
- To determine if FeNO measurements should precede EVH testing.
Main Methods:
- A 6-minute EVH test was administered to 234 children (aged 10-16).
- FeNO levels were measured before and after the EVH test in 153 children.
- Participants were categorized into low (FeNO < 20 ppb) and high (FeNO ≥ 20 ppb) baseline FeNO groups.
Main Results:
- FeNO levels decreased in 66% of children after the EVH test.
- Median FeNO levels dropped significantly in both low (10.5 to 9.5 ppb) and high (31.0 to 28.0 ppb) baseline groups (p < .011).
- The reduction in FeNO was not correlated with bronchoconstriction (change in FEV1).
Conclusions:
- EVH tests demonstrably lower FeNO levels in pediatric subjects.
- FeNO measurements should be performed prior to EVH testing for accurate clinical interpretation.
Keywords:
FeNOasthmaeucapnic voluntary hyperventilation testexhaled nitric oxideindirect bronchial challenge testMore Related Videos
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