Fractional exhaled nitric oxide and multiple breath nitrogen washout in preschool healthy and asthmatic children

Vilmann, Lea S.; Buchvald, Frederik; Green, Kent; Nielsen, Kim G.

doi:10.1016/j.rmed.2017.10.027

Cited by 20 publications

(25 citation statements)

References 37 publications

(47 reference statements)

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“…Among preschool children, results are controversial; in two studies from the same group, they found that symptomatic children or children with a history of severe disease had both elevated FE NO and LCI values compared with HC 16 30. In contrast, a recent study using the commercial N 2 MBW system found no differences in LCI or FE NO among a group of preschool outpatient asthmatics; however, other measures of ventilation heterogeneity such as S cond were elevated in this group 39. Other infant studies have also related higher single breath FE NO levels with a decline in lung function and wheeze exacerbations requiring systemic steroids 11.…”

Section: Discussionmentioning

confidence: 72%

Ventilation inhomogeneity in infants with recurrent wheezing

Foong²,

Kowalik

et al. 2018

Thorax

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Section: Discussionmentioning

confidence: 72%

Ventilation inhomogeneity in infants with recurrent wheezing

Foong²,

Kowalik

et al. 2018

Thorax

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“…We conducted a cross‐sectional observational study including children with CF and HC from CF Centre Copenhagen, Denmark and the Hospital of Sick Children, Toronto, Canada. The data used in this study are originally from measurements performed between 2011 and 2015 as part of the previously conducted studies at the two sites 4,9‐11 …”

Section: Methodsmentioning

confidence: 99%

Lung compartment analysis assessed from N₂ multiple‐breath washout in children with cystic fibrosis

Skov

Green

Stanojevic

et al. 2020

Pediatric Pulmonology

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Background Compartment analysis (CA) based on nitrogen multiple‐breath washout (N2MBW) has been shown to allow the assessment of specific volume and ventilation of faster‐ and slower‐ventilating lung compartments of the lung in adults with cystic fibrosis (CF). The aim of this study was to extend previous findings into the pediatric age range. Methods Cross‐sectional multicenter observational study in children with CF and healthy controls (HC) was done with the assessment of N2MBW and spirometry. A two‐lung compartment model‐based analysis (CA) was used to estimate size and function of faster‐ and slower‐ventilating lung compartments from N2MBW. Results A total of 125 children with CF and 177 HC, median age 10.8 (range, 2.8‐18.9) years, were included in the analysis. CA could be calculated in 66 (53%) children with CF compared with 48 (27%) HC (P < .0001). The proportion of the slower‐ventilating lung compartment was significantly smaller in children with CF (53.5%; 95% confidence interval [CI]: 51.9%‐55.7%) compared with HC (62.2%; 95% CI: 59.0%‐65.0%) The regional specific ventilation of the slower compartment (rVT,slow/rFRC,slow, %) was significantly lower in children with CF (4.9%; 95% CI: 4.5‐5.9) compared with HC (9.7%, 95% CI: 9.2‐10.9), and showed inverse correlation to lung clearance index (r2 = −.65; P < .0001), Sacin × VT (r2 = −.36; P = .003) and Scond × VT (r2 = −.51; P < .0001). There was no significant difference in pulmonary parameters between children with CF with and without feasible CA. Conclusion CA is less feasible in children than in adults and correlated to other MBW parameters. The clinical value of CA is still unclear and is yet to be established.

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“…Finally, one study reported MBW test results in 35 pre-school children aged 3-6 years with a doctor diagnosis of asthma [26]. No differences were found in LCI or S acin between the wheezy children and healthy controls but S cond was significantly elevated in the asthma group, suggesting the presence of conducting airways pathophysiology early in the disease process.…”

Section: The Role Of Washout Tests In Asthmamentioning

confidence: 99%

“…The site of ventilatory heterogeneity can be divided into abnormalities occurring predominantly in the acinar or the conducting airways. There is evidence of this in adults with COPD [24] and asthma [25], and indices of acinar and conductive airway ventilatory inhomogeneity are becoming a research focus [26,27].…”

Section: Introductionmentioning

confidence: 99%

Lung clearance index: assessment and utility in children with asthma

Nuttall

Velasquez²,

Beardsmore

et al. 2019

Eur Respir Rev

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There is increasing evidence that ventilation heterogeneity and small airway disease are significant factors in asthma, with evidence suggesting that the small airways are involved from an early stage in childhood asthma. Spirometry is commonly used to monitor lung function in asthmatics; however, it is not sensitive to small airway disease. There has been renewed interest in multibreath washout (MBW) tests, with recognition of the lung clearance index (LCI) as a global index of abnormality in gas mixing of the lungs that therefore also reflects small airway disease. This review summarises the technical and practical aspects of the MBW/LCI in children, and the differences between commercially available equipment. Children with severe asthma are more likely to have an abnormal LCI, whereas most children with mild-to-moderate asthma have an LCI within the normal range, but slightly higher than age-matched healthy controls. Monitoring children with asthma with MBW alongside standard spirometry may provide useful additional information.

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Fractional exhaled nitric oxide and multiple breath nitrogen washout in preschool healthy and asthmatic children

Abstract: The feasibility of measuring FeNO was highly age-dependent and not applicable in children under age 4. NMBW was feasible in the majority of preschool children. S, but not FeNO, could discriminate between children with asthma and healthy controls.

Cited by 20 publications

References 37 publications

Ventilation inhomogeneity in infants with recurrent wheezing

Ventilation inhomogeneity in infants with recurrent wheezing

Lung compartment analysis assessed from N₂ multiple‐breath washout in children with cystic fibrosis

Lung clearance index: assessment and utility in children with asthma

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Fractional exhaled nitric oxide and multiple breath nitrogen washout in preschool healthy and asthmatic children

Abstract: The feasibility of measuring FeNO was highly age-dependent and not applicable in children under age 4. NMBW was feasible in the majority of preschool children. S, but not FeNO, could discriminate between children with asthma and healthy controls.

Cited by 20 publications

References 37 publications

Ventilation inhomogeneity in infants with recurrent wheezing

Ventilation inhomogeneity in infants with recurrent wheezing

Lung compartment analysis assessed from N2 multiple‐breath washout in children with cystic fibrosis

Lung clearance index: assessment and utility in children with asthma

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Product

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Lung compartment analysis assessed from N₂ multiple‐breath washout in children with cystic fibrosis