Associação Entre a Fração Exalada De Óxido Nítrico E Dados Da Espirometria E O Controle Clínico Da Asma Em Crianças E Adolescentes

Abstract

Objective: To evaluate the association between fraction of exhaled nitric oxide (FeNO) values and forced expiratory volume in the first second (FEV1) and the level of asthma control, as proposed by the Global Initiative for Asthma (GINA), in asthmatic children and adolescents attended at the National Institute of Women, Children and Adolescents Health Fernandes Figueira of Fundação Oswaldo Cruz (IFF/FIOCRUZ).Methods: This was a cross-sectional study, with a review of medical records of 90 asthmatics between 7 and 17 years old, who were followed up at the IFF/FIOCRUZ Asthma Outpatient Clinic and were referred to perform respiratory function tests (RFT)between March 2013 and September 2014. After classification according to GINA, patients performed complete spirometry and FeNO measurement. Subsequently, they were separated into two groups: regular and non-regular inhaled corticosteroid (ICS) use, regardless of the ventilatory pattern in spirometry. Results: The association between FEV1 values and the degree of asthma control according to GINA (p=0.001) was observed in all patients, regardless of ICS use, but there was no association between FEV1 and levels of FeNO.Conclusions: The correlation observed between GINA and FEV1 reinforces the importance of spirometry in the clinical follow-up of these patients. Although no association was found between the value of FeNO and the degree of asthma control and FEV1, FeNO may be an early method to detect airway inflammation, even before the symptoms and spirometric changes.

A Longitudinal Study of a Selected Pediatric Asthmatic Population with Normal and Abnormal Spirometry at Baseline: An Emphasis on Treatment Outcomes

“…The reported prevalence, based on airflow obstruction, ranges from 23.5% to 60% in pediatric asthma. 6 , 10 , 11 , 15 Lo et al 10 studied 575 children with asthma treated in the United Kingdom and found that 23.5% had airflow obstruction. Another recent prospective study 15 reported that 27.5% of Thai children with well-controlled asthma still had airflow obstruction.…”

“… 9 , 10 However, many controversial issues remain regarding the use of lung function to classify asthma severity or predict future asthma outcomes in pediatric asthma studies. Data from 416 children in a controlled clinical trial 6 showed a significant association between pre-bronchodilator FEV1 and asthma outcomes. The lower the FEV1 percentage, the higher the risk of asthma exacerbation in the following 4 months.…”

“… 3 , 4 Children with asthma with a lower FEV1 percentage are more likely to have more severe disease and are at a higher risk of exacerbation. 6 , 7 However, a significant portion of symptom-controlled patients with asthma still have abnormal lung function. 8–11 …”