Exhaled nitric oxide in the management of childhood asthma: A prospective 6-months study
In: Pediatric Pulmonology, Jg. 41 (2006), S. 855-862
Online
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Zugriff:
Fractional exhaled nitric oxide (FeNO) is elevated in asthma and reflects eosinophilic airway inflammation. The aim of this prospective, randomized, single-blind study was to examine whether the inclusion of repeated FeNO measurements into asthma monitoring leads to an improvement in asthma outcome. Forty-seven children with mild to moderate asthma were allocated to a FeNO group (n = 22) and to a control group (n = 25). In the FeNO group therapy was based on symptoms, beta-agonist use, lung function, and FeNO whereas in the control group therapy was based on symptoms, beta-agonist use and lung function only. Patients performed five visits in 6 weeks intervals. Frequency of respiratory symptoms, beta-agonist use, FEV(1)% predicted and the frequency of exacerbations were similar between groups. Patients in the FeNO group received higher doses of inhaled corticosteroids (ICS) (control group: median (interquartile range): 241 microg (26-607 microg); FeNo group: 316 microg (200-500 microg) and had significantly higher MEF(50)% predicted (control group: median (interquartile range): 68.5% (55.8-83.1%); FeNO group: 83.2% (62.9%-98.3%). At a cut-off point of 22.9 ppb FeNO the best predictive value for exacerbations with a sensitivity of 80% and specificity of 60% was found. Significant relationships were observed between FeNO and dose of ICS (beta = -8.77; P < 0.002), beta-agonist use 2 weeks prior to a visit (beta = 0.11; P < 0.05), asthma symptoms (beta = 0.02; P < 0.0001), and bronchial hyperresponsiveness (beta = 0.04; P = 0.02). In conclusion, FeNO was related to important markers of asthma control. A therapy regimen aimed at lowering FeNO in children with asthma improved parameters of small airway function, but was not able to improve clinical markers of asthma control.
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Exhaled nitric oxide in the management of childhood asthma: A prospective 6-months study
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Autor/in / Beteiligte Person: | Dehlink, Eleonora ; Putschoegl, Bettina ; Szépfalusi, Zsolt ; Horak, Friedrich ; Frischer, Thomas ; Uxa, Sabine ; Fritsch, Maria |
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Zeitschrift: | Pediatric Pulmonology, Jg. 41 (2006), S. 855-862 |
Veröffentlichung: | Wiley, 2006 |
Medientyp: | unknown |
ISSN: | 1099-0496 (print) ; 8755-6863 (print) |
DOI: | 10.1002/ppul.20455 |
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