Single Breath Analysis of Endogenous Nitric Oxide in the Newborn

Artlich, A.; Jónsson, Baldvin; Bhiladvala, Maneck; Lönnqvist, Per Arne; Gustafsson, Lars E.

doi:10.1159/000047061

Cited by 27 publications

(25 citation statements)

References 22 publications

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“…In our study, expired NO concentrations in term and preterm infants were lower than those reported for adults and older children according to published data [2,13,14,18,19,24]. Term infants excrete a greater amount of NO in the upper airways in the first hours of life compared to later sampling times, suggesting a role of NO in early postnatal respiratory adaptation.…”

Section: Discussionsupporting

confidence: 58%

“…The paranasal sinuses are only partially pneumatized in the newborns so that NO might be lower than in older subjects [13]; nevertheless autoinhalation of NO produced in upper airways seems to play a role in the adaptation of the respiratory system to postnatal life [14][15][16][17]. Few studies have evaluated endogenous NO production in the airways of newborns and its role in physiological and pathological circumstances [4,13,18,19]. The aim of this study was to measure the exhaled NO (eNO) in the respiratory system of healthy newborn infants according to their gestational and postnatal age.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endogenous Nitric Oxide Production in the Airways of Preterm and Term Infants

Condò¹,

Pugni²,

Fumagalli³

et al. 2003

Neonatology

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Few studies have measured endogenous nitric oxide exhaled from the respiratory system of newborn infants. We measured exhaled nitric oxide (eNO) in the first 48 h of life in 24 (13 preterm, 11 term) spontaneously breathing (online method) newborns using a chemoluminescence analyzer. There was a significant difference in the eNO concentration between term and preterm healthy infants in the first 2 days of life (repeated measures analysis of variance, p < 0.05). In term infants there is a peak eNO production in the first hours of life, suggesting a potential role in postnatal adaptation, while in preterm infants eNO production is almost absent at birth, and then gradually increases.

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Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Endogenous Nitric Oxide Production in the Airways of Preterm and Term Infants

Condò¹,

Pugni²,

Fumagalli³

et al. 2003

Neonatology

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“…This would also imply that our study underestimates any differences between groups. However, it has been shown that both nasal and oral NO levels reflect mixed exhaled NO in infants (28) and techniques to avoid nasal contamination of exhaled air in infants require complicated and demanding equipment, unlikely to become useful in practice (30,31). Also, standardization for expiratory flow in infants is technically possible, but difficult (20), and may be unnecessary.…”

Section: Discussionmentioning

confidence: 99%

Exhaled Nitric Oxide Differentiates Airway Diseases in the First Two Years of Life

et al. 2006

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Fractional exhaled nitric oxide (FE NO ) levels are increased in children and adults with asthma, whereas low levels have been found in cystic fibrosis and primary ciliary dyskinesia. The aim of this study was to investigate whether FE NO measurements could distinguish between children below the age of 2 with different airway diseases. FE NO measurements were performed in 118 infants aged between 4.6 and 25.2 mo: 74 infants with recurrent wheezing (RW), 24 with bronchopulmonary dysplasia (BPD), and 20 with cystic fibrosis (CF). FE NO was measured also in 100 healthy controls aged between 1.1 and 7.7 mo. Geometric mean (95% confidence interval) FE NO values were 10.4 (9.1-12.0) parts per billion (ppb) in healthy infants, 18.6 (15.6 -22.2) ppb in wheezy infants, 11.7 (8.2-16.8) ppb in BPD infants and 5.9 (3.4 -10.1) ppb in CF infants. FE NO in wheezers was higher than in controls, BPD, and CF (p ϭ 0.009, p ϭ 0.038, and p Ͻ 0.001, respectively). Atopic wheezers showed higher FE NO than nonatopic wheezers (p ϭ 0.04). CF infants had lower FE NO than healthy controls and BPD infants (p ϭ 0.003 and p ϭ 0.043, respectively). FE NO values in BPD and control infants were not different. We conclude that FE NO is helpful to differentiate various airway diseases already in the first 2 y of life. T he fractional concentration of nitric oxide in exhaled air (FE NO ) has been suggested as a marker of bronchial eosinophilic inflammation. Increased FE NO levels have been found in asthmatic adults (1) and children with symptoms of asthma and atopy (2). Guidelines for the measurement of FE NO are available for both adults and children (3,4), and normal values for healthy children between 4 and 17 y of age have been recently published (5). Although in the last decade there has been a growing interest in measuring FE NO in noncooperative young children as well, few studies have investigated FE NO as a marker of bronchial inflammation in children below the age of 2 y. It has been shown that infants with recurrent wheeze have elevated levels of FE NO during exacerbations that rapidly decrease after steroid therapy (6), suggesting that eosinophilic airway inflammation is present in early childhood wheeze. Low FE NO levels have been found in infants with CF (7), primary ciliary dyskinesia (8) and rhinorrhea (9). A recent study by Baraldi and co-workers (10) showed that school-age children with BPD and airflow limitation had lower FE NO levels than healthy matched controls and asthmatic children, suggesting that airflow limitation in children with BPD might not be related to ongoing inflammation as is the case in asthma. It is well known that infants with BPD have an early inflammatory response followed by chronic inflammation and airways remodeling (11-13). Only one study previously reported high FE NO levels in infants with chronic lung disease (14).The aim of the present study was to measure FE NO in infants below the age of 2 y and to evaluate whether FE NO could be used to differentiate airways diseases in the first 2 y of ...

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“…In newborns, paranasal sinuses are not yet developed. However, the nose is also the primary NO source in newborns, with low levels of NO coming from the lower respiratory tract [55].…”

Section: Nasal Nitric Oxide Productionmentioning

confidence: 99%

“…Both on-line and off-line methods have been applied in infants and neonates without the use of sedatives [55,73,81].…”

Section: Tidal Breathing Techniquesmentioning

confidence: 99%