Measurement of FeNO with a portable, electrochemical analyzer using a 6-second exhalation time in 7–10-year-old children with asthma: comparison to a 10-second exhalation

Rickard, Kathleen; Jain, Neal; MacDonald-Berko, Margot

doi:10.1080/02770903.2018.1541350

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…While all children aged 8 years and more (n=21) completed FeNO measurement for both durations, for children <8 years (n=25) the success rates were 60.0% (10 s) and 92.0%, (6 s), respectively. Rickard et al reported very similar findings in children aged 7-10 years old with a median bias of 0.5 ppb [4]. Thus, our demonstration of the excellent precision and equivalence of the 6 to the 10 s exhalation agrees with these reports [3] and opens the way to application of great relevance to very young children.…”

Section: Discussionsupporting

confidence: 89%

Clinical precision, accuracy, number and durations of exhalations for a novel electrochemical monitor for exhaled nitric oxide

Silkoff¹,

Awabdy²,

Sarno³

et al. 2019

J. Breath Res.

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Background: Exhaled nitric oxide (FeNO) is a validated marker of eosinophilic inflammation. Fenom ProTM is a novel FDA-cleared monitor for FeNO. The American Thoracic Guidelines from 2005 recommend at least 6 s exhalation for adults and in some cases up to 10 s, and 4 s for children, and that the average of the first two valid exhalations is taken as the FeNO value. Methods: Clinical precision, 6 versus 10 s exhalations, the first versus the average of the first two valid exhalation methods comparison were evaluated for Fenom ProTM, as well as a methods comparison to the NIOX VERO® monitor. Results: The intent-to-treat population (n = 126) consisted of 83 adults, and 43 pediatric subjects with 16 subjects under 12 years of age. Clinical precision for 10 s exhalations on Fenom ProTM was excellent with a within-subject standard deviation (SD) range of 0.57–3.73 ppb and mean coefficient of variation (CV) range of 4.21% to 9.65%. The clinical precision for the separate adult and pediatric groups as well as for the 6 s exhalations were similar. The 10 and 6 s exhalation comparisons and one versus the average of two valid exhalations showed a high level of agreement. The Fenom ProTM and the NIOX VERO® monitors also demonstrated a high level of agreement with the values from the latter slightly lower (mean bias of −3.2 ppb). Conclusion: Fenom ProTM demonstrated eminently acceptable performance supporting its clinical utility. The data suggests that 6 s exhalations can be used in adults and children, and that one exhalation is adequate rather than obtaining the average of two exhalations on Fenom ProTM.

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Section: Discussionsupporting

confidence: 89%

Clinical precision, accuracy, number and durations of exhalations for a novel electrochemical monitor for exhaled nitric oxide

Silkoff¹,

Awabdy²,

Sarno³

et al. 2019

J. Breath Res.

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“…As far as the field of pediatrics is concerned, compliance is one of the major impediments to using sampling at younger ages. Portable analyzers, like those used in the Clinic of Pediatrics at the Filantropia Municipal Hospital in Craiova, have made this determination more accessible, but -as with classic pulmonary function tests -the age of 5-6 years seems to be a threshold below which it is difficult to get valid results [22]. There are methods to allow on-line assessment of nitric oxide in exhaled air for smaller children, but they are only available in specialized centers and no sufficiently large amount of data has been collected to be able to include them in current practice.…”

Section: Discussionmentioning

confidence: 99%

Electrochemical Detection of the Exhaled Nitric Oxide in Children

Diaconu¹,

Dumitrescu²,

Stoica³

et al. 2020

Rev. Chim.

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Dosage of gaseous inflammatory markers is a promising method of evaluating various types of pediatric pathologies and not only. The fraction of exhaled nitric oxide (FeNO) can be quantified by electrochemical detection using a portable analyzer that delivers fast, reproducible, and widely available results. The objectives of our study were to evaluate the accessibility of the pediatric dosing method and the utility of FeNO for the diagnosis of atopic pathology in hospitalized children. We conducted a retrospective study that included children aged over 6 years admitted to the Pediatric Department of the Municipal Hospital Filantropia in Craiova who were evaluated according to the type of training performed for the determination of FeNO and according to the diagnosis of admission. Results. Using a human model was more effective in obtaining a valid result compared to the use of the demo provided by the manufacturer, especially at younger age (p = 0.05 and respectively, 0.04 - Student t test). Among the various allergic pathologies studied, children with asthma were the ones who recorded the highest levels of nitric oxide, even when compared to the rest of atopic children (p = 0.01 - t test). Moreover, the proportion of cases with positive values was increased in asthmatic children compared to the rest of the type of allergic pathology, but these values were at the limit of statistical significance (p = 0.08 - chi square and Mid-P exact test). The conclusion of our study was that it is possible to improve compliance with FeNO assessment especially at younger age, and the utility of the method is still limited, especially in asthma cases.

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“…The main determinant of raised FeNO levels is atopy and asthma [23][24][25]. FeNO is an independent risk factor for asthma and allergic sensitization [26], and in school-age children it is used for clinical monitoring [27] in order to distinguish allergic rhinitis from nonallergic rhinitis [28].…”

Section: Discussionmentioning

confidence: 99%

Morning Fractional Exhaled Nitric Oxide in Children with Recurrent Desaturation During Sleep

Nosetti¹,

Cairati

Agosti

et al. 2020

BJSTR

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Objective: The aim was to assess the relationship between morning fractional exhaled NO (FeNO) and nocturnal oxygen desaturation in children. Design: prospective study. Setting: The study was conducted from January 2012 to January 2018, in the division of pediatric at tertiary-care hospital.Patients: Of the total of 112 children initially enrolled, 109 (case children; 65.1% males; age 7.0± 3.1 years) met the criteria of the oxygen desaturation index (≥ 1 desaturations measured by pulse oximetry). An additional 63 healthy children (controls, 60.3% males; age 7.9±2.9 years) were enrolled as external controls. Children underwent pulse oximetry (172 subjects), were assessed for FeNO and for inhalant allergens (skin prick test). Comorbidities were allergy and obesity. Methods: Nocturnal at-home oximetry and morning FeNO levels.Results: FeNO levels was comparable between case children without comorbidities and controls (p = 0.346). FeNO levels were much higher in case children with atopy compared to controls (p=0.0011) and in those with atopy and overweight compared to controls (p<0.0001) while FeNO levels increased in case children overweight compared to controls (p=0.0311). Conclusion:Atopy was the main determinant of elevated FeNO levels in children with nocturnal oxygen desaturation. A novel finding is that the FeNO levels were significantly increased in obese children as compared to controls. Further studies are needed to confirm our findings and to compare FeNO levels in obese children with or without recurrent desaturation events during sleep.

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Measurement of FeNO with a portable, electrochemical analyzer using a 6-second exhalation time in 7–10-year-old children with asthma: comparison to a 10-second exhalation

Cited by 5 publications

References 26 publications

Clinical precision, accuracy, number and durations of exhalations for a novel electrochemical monitor for exhaled nitric oxide

Clinical precision, accuracy, number and durations of exhalations for a novel electrochemical monitor for exhaled nitric oxide

Electrochemical Detection of the Exhaled Nitric Oxide in Children

Morning Fractional Exhaled Nitric Oxide in Children with Recurrent Desaturation During Sleep

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