Tidal breath eNO measurements in a cohort of unsedated hospitalized neonates—A method validation

Schmidt, B; Reim, Pauline S.; Jensen, Andreas Kryger; Albertsen, Per; Greisen, Gorm; Jørgensen, Inger Merete

doi:10.1002/ppul.24019

Cited by 4 publications

(22 citation statements)

References 43 publications

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“…One thousand five hundred mothers were included before birth in the AD‐ON research biobank at Nordsjaellands Hospital, Denmark, from September 2013 to September 2014 6 …”

Section: Methodsmentioning

confidence: 99%

“…Participants underwent at least three 60‐s measurements during tidal breathing, including sighs and apneas. The mean value of two 60‐s FeNO measurements, with a maximum difference of 1 ppb, was used to include as many valid measurements as possible and still in accordance with the method validated by Schmidt et al 6 All infants were scheduled for six visits for FeNO measurements during the first month of life.…”

Section: Methodsmentioning

confidence: 99%

“…Tidal breath exhaled nitric oxide (eNO) is a noninvasive measurement that is well‐tolerated by neonates from the first days of life 6,7 . Exhaled NO is a marker of eosinophil inflammation and, in children and adults, it is used as a tool for the diagnosis and monitoring of asthma 8,9 .…”

Section: Introductionmentioning

confidence: 99%

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Neonatal FeNO, risk factors, and respiratory morbidity in infants: A cohort study

Goth

Schmidt

Green

et al. 2021

Pediatric Pulmonology

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Background Respiratory symptoms in infancy are more common in premature infants. Nitric oxide (NO) is involved in prenatal and neonatal lung development. Measurement of exhaled NO is easy and well‐tolerated by neonates. We investigated whether neonatal exhaled NO can be used to predict subsequent respiratory symptoms. Furthermore, we sought to determine prenatal and postnatal factors associated with increased respiratory symptom risk during the first year of life in premature and mature infants. Methods Tidal fractional exhaled NO (FeNO) was measured in a birth cohort (n = 135) of premature and mature infants, up to six times during the first month of life. Primary outcomes were troublesome respiratory symptoms (TRS) and doctor‐diagnosed asthmatic bronchitis (AB) at 1 year of age. Findings The correlation between FeNO and TRS changed significantly in an age‐dependent pattern in moderately premature infants (p = .02). Moderately premature infants with a low FeNO of 2 ppb on postnatal Day 3 had a 48% (95% confidence interval [CI]: 17%–80%) probability of TRS, compared with a probability of 12% (95% CI: 1%–64%) for otherwise similar infants with a FeNO of 11 ppb. Respiratory syncytial virus infection and parental smoking significantly increased the TRS risk in premature infants. Parental asthma and maternal antibiotic use during pregnancy significantly increased the TRS risk in mature infants. Interpretation An age‐specific association between neonatal FeNO and respiratory symptoms was seen in moderately premature infants. TRS risk was associated with postnatal factors in premature and prenatal factors in mature infants.

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“…One thousand five hundred mothers were included before birth in the AD‐ON research biobank at Nordsjaellands Hospital, Denmark, from September 2013 to September 2014 6 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Neonatal FeNO, risk factors, and respiratory morbidity in infants: A cohort study

Goth

Schmidt

Green

et al. 2021

Pediatric Pulmonology

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“…Every measurement was performed Open access over 60 s at least three times to obtain three measurements with maximal FeNO deviance of 1 ppb. 45 Measurements were performed on postnatal days 3, 5, 7, 14, 21 and 28, and again at 1-year follow-up. At the 6-year follow-up, FeNO was measured by single breath exhalation with Ecomedics CLD 88sp according to the ERS and the ATS guidelines.…”

Section: Feno Measurementsmentioning

confidence: 99%

“…Every measurement was performed over 60 s at least three times to obtain three measurements with maximal FeNO deviance of 1 ppb. 45 …”

Section: Cohort Descriptionmentioning

confidence: 99%

Cohort profile: the vitamin A and D and nitric oxide (AD-ON) observational cohort on lung development and symptoms in premature and mature children in North Zealand, Denmark

et al. 2022

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PurposeThe risk of developing asthma-like symptoms and asthma in childhood is influenced by genetics, environmental exposures, prenatal and early postnatal events, and their interactions. The cohort name refers to vitamins A and D, and nitric oxide (NO) spelt backwards and this cohort profile paper aims to present the data collection and aim of the cohort.The overall aim when establishing this cohort was to investigate if childhood lung function can be traced back to early neonatal lung function and fractional exhaled NO (FeNO) and investigate prenatal and postnatal risk factors including maternal and neonatal vitamin A and D levels in preterm and term born children.ParticipantsOne thousand five hundred women and their babies born at Nordsjaellands Hospital in Denmark from 2013 to 2014 were included in the AD-ON research biobank prior to birth.Neonates from the AD-ON research biobank, admitted to the Neonatal Intensive Care Unit at Nordsjaellands Hospital, were included in the AD-ON neonatal cohort. The neonatal cohort consisted of 149 neonates hereof 63 preterm and 86 term born. The children in the cohort have been invited to follow-up visits at age 1 and 6 years.Findings to datePublished data from this cohort includes a validated and clinically applicable method to measure FeNO in neonates. We found an age-specific pattern of association between respiratory symptoms at age 1 and neonatal FeNO in preterm children. Moreover, we found that the respiratory symptoms risk was associated with postnatal factors (Respiratory Syncytial Virus infection and parental smoking) in preterm infants and prenatal factors (parental asthma and maternal infection during pregnancy) in term born infants.Future plansIn the future, the children will be examined continuously with 3-year to 5-year intervals until the age of 18. Lung function, allergy tests, environmental exposure measurements and questionnaires will be collected at each follow-up visit.

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From neonatal lung function to lung function and respiratory morbidity at 6‐year follow‐up

Goth

Green

Hansen

et al. 2022

Pediatric Pulmonology

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Background: Lung function is traceable from infancy to adulthood. Only a few studies have examined lung function from birth to childhood longitudinally in children born moderate to late preterm. We aimed to investigate how prematurity and lung function in the neonatal period are related to lung function and respiratory morbidity at age 6 in former moderate to late preterm children compared with children born at term. Methods: Lung function was measured in a cohort of moderately to late preterm (n = 48) and term-born (n = 53) infants in the neonatal period by FeNO, and tidal breathing flowvolume loops (TBFVL) and at age 6 (n = 52) by spirometry, whole-body plethysmograph and impulse oscillation combined with a respiratory symptom questionnaire.Results: Moderate to late preterm children had a higher T PEF /T E ratio neonatally (42.6% vs. 33.7%, p = 0.02) and a lower % predicted orced expiratory volume in the first second at age 6 (94.4% vs. 101.9%, p = 0.01) compared to term-born children.We found a significant association between the variability of neonatal tidal volume and effective airway resistance at age 6 (β = −0.34, p = 0.03). No association between neonatal FeNO or TBFVL and respiratory morbidity at 6-year follow-up was shown. Conclusion:Children born moderate to late preterm had lower lung function at age 6 than term-born children. We did not find evidence for the use of neonatal tidal breathing parameters as a predictor for subsequent respiratory morbidity or lung function, however sample size was small.

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Tidal breath eNO measurements in a cohort of unsedated hospitalized neonates—A method validation

Abstract: We validated clinically, non-invasive, online eNO measurements in neonates. The method was well tolerated and exhibited low subject-specific-prediction-variance and high success rates.

Cited by 4 publications

References 43 publications

Neonatal FeNO, risk factors, and respiratory morbidity in infants: A cohort study

Neonatal FeNO, risk factors, and respiratory morbidity in infants: A cohort study

Cohort profile: the vitamin A and D and nitric oxide (AD-ON) observational cohort on lung development and symptoms in premature and mature children in North Zealand, Denmark

From neonatal lung function to lung function and respiratory morbidity at 6‐year follow‐up

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