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The Role of Fractional Exhaled Nitric Oxide and Oscillometry in Pediatric Asthma
1Dr. Davis is affiliated with Wells Center for Pediatric Research/Pulmonology, Allergy, and Sleep Medicine, Riley Hospital for Children at Indiana University School of Medicine, Indianapolis, Indiana, USA.
Insights
Diagnosing pediatric asthma is challenging. This review explores fraction of exhaled nitric oxide (FENO) and impulse oscillometry as easier lung function tests for children, aiding asthma diagnosis and monitoring.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Diagnostics
Background:
- Pediatric asthma diagnosis is complex, requiring assessment of symptoms, inflammation, and lung function.
- Spirometry is challenging for young children, especially those under 5.
- Fraction of exhaled nitric oxide (FENO) measures type 2 airway inflammation but has debated utility in pediatric asthma.
Purpose of the Study:
- To review current pediatric asthma diagnosis and monitoring guidelines.
- To evaluate the role of FENO measurement in pediatric asthma.
- To assess the utility of impulse oscillometry as an alternative lung function test for children.
Main Methods:
- Narrative review of recent pediatric asthma guidelines.
- Overview of FENO measurement applications in pediatric asthma.
- Analysis of impulse oscillometry's feasibility compared to spirometry in children.
Main Results:
- Spirometry is often not feasible in young pediatric patients.
- FENO measurement's role in diagnosis and monitoring remains under discussion.
- Impulse oscillometry may offer a more accessible method for assessing lung function in pediatric asthma.
Conclusions:
- Recent guidelines for pediatric asthma diagnosis and monitoring were evaluated.
- The use of FENO and impulse oscillometry in pediatric asthma was discussed.
- The article concludes with a panel discussion on the clinical roles of FENO and impulse oscillometry.
Abstract:
Diagnosing pediatric asthma is challenging and requires the evaluation of symptoms, inflammation, and lung function. Spirometry, which is commonly used to evaluate lung function in asthma, is difficult to obtain from young pediatric patients and frequently not possible to obtain from patients under 5 years of age. This is also true for the fraction of exhaled nitric oxide (FENO) measurement, which can indicate type 2 airway inflammation in asthma, and controversy has existed regarding the appropriate use of FENO measurement in asthma diagnosis and monitoring. Impulse oscillometry can be used to evaluate lung function and may be easier to perform than spirometry for pediatric patients. This narrative review evaluates the recent guidelines for diagnosis and monitoring of pediatric asthma. It also provides an overview of the use of FENO measurement and impulse oscillometry in pediatric asthma. A panel discussion of the role of FENO measurement and impulse oscillometry in pediatric asthma concludes this article.
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