Establishing normative nasal nitric oxide values in infants

Adams, Phillip S.; Tian, Xin; Zahid, Maliha; Khalifa, Omar; Leatherbury, Linda; Lo, Cecilia W.

doi:10.1016/j.rmed.2015.07.010

Cited by 25 publications

(31 citation statements)

References 36 publications

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“…Measurement of nNO in young children is possible, however discrimination between PCD patients and controls is reduced as nNO is inversely proportional to age in healthy patients under 12 years[28, 29]. One study showed that velum closure was possible in children as young as 3.9 years [20].…”

Section: Resultsmentioning

confidence: 99%

European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia

et al. 2016

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The diagnosis of primary ciliary dyskinesia is often confirmed with standard, albeit complex and expensive tests. In many cases, however, the diagnosis remains difficult despite the array of sophisticated diagnostic tests. There is no ‘gold standard’ reference test. Hence, a task force supported by the European Respiratory Society has developed this guideline to provide evidence-based recommendations on diagnostic testing, especially in the light of new developments in such tests, and the need for robust diagnoses of patients who might enter randomised controlled trials of treatments. The guideline is based on pre-defined questions relevant for clinical care, a systematic review of the literature, and assessment of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. It focuses on: clinical presentation, nasal nitric oxide, analysis of ciliary beat frequency and pattern by high-speed video-microscopy analysis, transmission electron microscopy, genotyping and immunofluorescence. It then used a modified Delphi survey to develop an algorithm for the use of diagnostic tests to definitively confirm and exclude the diagnosis of PCD; also to provide advice when the diagnosis is not conclusive. Finally, this guideline proposes a set of quality criteria for future research on the validity of diagnostic methods for PCD.

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Section: Resultsmentioning

confidence: 99%

European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia

et al. 2016

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“…10,11 Infants were classified as having normal or low nNO based on the published prediction interval of normative infant nNO values. 12…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…Our patient cohort had a median PLOS of 15 [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] days ( Table 2). The median total CICU LOS was 8 [5][6][7][8][9][10][11] days, and initial CICU LOS was 7 [5][6][7][8][9][10][11] days.…”

Section: Postoperative Outcome Assessmentsmentioning

confidence: 99%

Airway ciliary dysfunction: Association with adverse postoperative outcomes in nonheterotaxy congenital heart disease patients

Stewart

Adams

Tian

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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Non-HTX CHD infants with abnormal CM showed increased postoperative morbidity associated with poor respiratory outcomes. In contrast, low nNO correlated with reduced hemodynamic function. These findings suggest screening for abnormal CM may allow perioperative interventions to reduce pulmonary morbidities. Whether low nNO may prognosticate poor hemodynamic function warrants further investigation.

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“…19 nNO values (nl/min) were acquired using a CLD88sp chemiluminescence NO analyzer (EcoPhysics, Ann Arbor, MI). Patients were categorized as having normal or low nNO based on established cutoff values from the literature 17, 18, 20…”

Section: Methodsmentioning

confidence: 99%

Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation

Adams

Zahid

Khalifa

et al. 2017

JAHA

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BackgroundNO bioavailability has not been systematically examined in congenital heart disease (CHD). To assess NO in patients with CHD, we measured nasal NO (nNO) generated by the nasal epithelia, given blood NO is difficult to measure (half‐life, <2 ms). Given NO's role in hemodynamic regulation and the association of NO bioavailability with heart failure risk, we hypothesized NO levels may differ with varying severity of CHD physiologic characteristics.Methods and ResultsSix‐hundred eighteen subjects, 483 with CHD and 135 controls, had nNO measured noninvasively via the nares using American Thoracic Society/European Respiratory Society guidelines. Subjects were dichotomized as having low or normal nNO based on age‐specific cutoff values. Prevalence of low nNO was examined by various CHD physiologic feature types. Low nNO was more prevalent with CHD than controls (odds ratio, 2.28; P=0.001). A logistic regression model showed overall significance (P=0.035) for single ventricle, systemic right ventricle, ventricular dysfunction, oxygen desaturation, and heterotaxy predicting low nNO, with systemic right ventricle independently having twice the odds of low nNO (odds ratio, 2.04; P=0.014). Patients with low nNO had a higher risk of experiencing heart transplant or death (hazard ratio, 2.75; P=0.048), and heart transplant recipients (N=16) exhibited 5 times the odds of low nNO (69% versus 30%; odds ratio, 5.1; P=0.001).ConclusionsPatients with CHD have increased prevalence of low nNO, with highest odds seen with systemic right ventricle and heart transplant. Further studies are needed to investigate heart failure risks in patients with CHD with left versus right systemic ventricle physiologic characteristics and utility of low nNO for predicting heart failure risk.

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Establishing normative nasal nitric oxide values in infants

Cited by 25 publications

References 36 publications

European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia

European Respiratory Society guidelines for the diagnosis of primary ciliary dyskinesia

Airway ciliary dysfunction: Association with adverse postoperative outcomes in nonheterotaxy congenital heart disease patients

Low Nasal NO in Congenital Heart Disease With Systemic Right Ventricle and Postcardiac Transplantation

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