Measurement of expired nitric oxide levels in children

Nitric oxide (NO) can be measured directly in expired air in adults. The purpose of our study was to measure NO levels in children and to compare these values with adults. Exhaled NO was measured in 39 normal prepubertal children (23 girls), aged 9-11 years (mean 9.9 years). Exhaled NO was measured by the chemiluminescence method that is sensitive in a range of 2 to 4,000 ppb of NO on an adapted analyzer (Dasibi Environmental). Wearing a nose clip. 5 measurements were recorded in each child with exhalation 1) directly into the NO analyzer (flow rate 240 mL/min) with measurements of NO, carbon dioxide, and mouth pressure; and 2) using a T-piece to allow measurements at a different flow rate. For all measurements, background NO levels were less than 10 ppb. The mean direct level was 49.6 ppb, SD 37.8 (range, 11.5-197.2 ppb) compared with T-piece levels of 29.2 ppb. SD 27.1 (range, 5.1-141.2 ppb). There was no significant difference between boys and girls for direct or T-piece recordings. Mean direct NO in boys was 43.1 ppb, SD 40.5 and in girls 55.2 ppb, SD 35.4; mean T-piece in boys was 25.6 ppb. SD 29.2 and in girls 33.8 ppb, SD 25.1. Mean NO levels in prepubertal children are lower than in adults and show no difference between males and females.