Perioperative changes in exhaled nitric oxide during oesophagectomy

Boshier, Piers R.; Knaggs, Alison; Hanna, George B.; Marczin, Nándor

doi:10.1088/1752-7163/aa9387

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…Theoretically, ETNO was the de nitive approach to eNO in pulmonary alveoli below 5 ppb. In another experiment, the investigator observed perioperative changes in eNO during oesophagectomy, the level of eNO was approximately 3 ppb [11]. However, the level in our study was approximately 10 ppb.…”

Section: Discussioncontrasting

confidence: 75%

“…The ventilated lung unbalances the production and consumption of NO by destroying the endothelium and inducing in ammatory and oxidative stress; the change in NO indicates lung injury. Currently, exhaled breath condensate nitrite and nitrate, the metabolism of NO in the lungs, has been measured frequently for assessing lung injury in ventilated patients [10][11][12]. As a more direct index, eNO collected during ventilation may be a new and convenient in ammatory marker of lung injury.…”

Section: Introductionmentioning

confidence: 99%

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PEAK End-Tidal NO as a biomarker for investigating the effect of different OLV strategies on lung injury and inflammation response.

zhang,

Jiang,

wang

et al. 2024

Preprint

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One-lung ventilation (OLV) aggravates alveolar damage and inflammation response in the lung. The evaluation indicators of lung injury caused by OLV are not perfect. End-tidal fraction of nitric oxide (ETNO) continuously collected during ventilation may be a new and non-invasive inflammatory marker of lung injury to investigate the effect of different OLV strategies. A total of 56 patients undergoing thoracic surgery were included and randomized into two groups. These patients had the same parameters during two-lung ventilation, but during OLV, the High-Volume group was set at a tidal volume (VT)=8 ml/kg predicted body weight (PBW) and a positive end-expiratory pressure (PEEP)=5 cmH2O, while the Low-Volume group was set at a VT=5 ml/kg PBW and a PEEP=5 cmH2O with recruitment every 30 min. ETNO was acquired at the points of induction, OLV 0 min, OLV 15 min, OLV 30 min, OLV 1 h and immediately at two-lung re-ventilation. We also obtained traditional evaluation indicators at the same points. ETNO did not differ significantly between groups at baseline. When the patients suffered OLV, compared with the Low-Volume group, ETNO in the High-Volume group significantly decreased at all points (P<0.001), and the expression of endothelial NO synthase in plasma decreased but lagged for a quarter. There was almost no change in traditional inflammatory factor in plasma. Compared with traditional inflammatory factor, ETNO can be a new, rapid, convenient and accurate inflammatory marker for investigating the effects of different OLV strategies in early-phase lung injury and pro-inflammation response. Clinical trial registration.ChiCTR1800015993

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Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

PEAK End-Tidal NO as a biomarker for investigating the effect of different OLV strategies on lung injury and inflammation response.

zhang,

Jiang,

wang

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Gashouta et al [ 21 ] reported that an increase in NO concentration was correlated with acute rejection, lymphocytic bronchiolitis, or acute infection after lung transplantation. Boshier et al [ 22 ] also found the NO concentration tended to be elevated in patients with POP who underwent esophagectomy. We have detected a significant difference in post-op-FeNO and ∆FeNO values between POP and non-POP groups.…”

Section: Discussionmentioning

confidence: 98%

Perioperative Exhaled Nitric Oxide as an Indicator for Postoperative Pneumonia in Surgical Lung Cancer Patients: A Prospective Cohort Study Based on 183 Cases

Liu

Yang

Chen

et al. 2022

Canadian Respiratory Journal

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Introduction. This study is conducted to investigate the correlation between perioperative fractional exhaled nitric oxide and postoperative pneumonia (POP) and the feasibility of perioperative FeNO for predicting POP in surgical lung cancer patients. Methods. Patients who were diagnosed with non-small-cell lung cancer (NSCLC) were prospectively analyzed, and the relationship between perioperative FeNO and POP was evaluated based on patients’ basic characteristics and clinical data in the hospital. Results. There were 218 patients enrolled in this study. Finally, 183 patients were involved in the study, with 19 of them in the POP group and 164 in the non-POP group. The POP group had significantly higher postoperative FeNO (median: 30.0 vs. 19.0 ppb, P < 0.001 ) as well as change in FeNO (median: 10.0 vs. 0.0 ppb, P < 0.001 ) before and after the surgery. For predicting POP based on the receiver operating characteristic (ROC) curve, a cutoff value of 25 ppb for postoperative FeNO (Youden’s index: 0.515, sensitivity: 78.9%, and specificity: 72.6%) and 4 ppb for change in FeNO (Youden’s index: 0.610, sensitivity: 84.2%, specificity: 76.8%) were selected. Furthermore, according to the bivariate regression analysis, FEV1/FVC (OR = 0.948, 95% CI: 0.899–0.999, P = 0.048 ), POD1 FeNO (OR = 1.048, 95% CI: 1.019–1.077, P = 0.001 ), and change in FeNO (OR = 1.087, 95% CI: 1.044–1.132, P < 0.001 ) were significantly associated with occurrence of POP. Conclusions. This prospective study revealed that a high postoperative FeNO (>25 ppb), as well as an increased change in FeNO (>4 ppb), may have the potential in detecting the occurrence of POP in surgical lung cancer patients.

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Preoperative fractional exhaled nitric oxide is a risk and predictive factor of postoperative cough for early-stage non-small cell lung cancer patients: a longitudinal study

Lin,

Yu,

2024

BMC Pulm Med

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Background To determine whether preoperative fractional exhaled nitric oxide (FENO) level is a risk and predictive factor of postoperative cough by using the Leicester Cough Questionnaire in Mandarin-Chinese (LCQ-MC). Methods 292 early-stage non-small cell lung cancer (NSCLC) patients without preoperative cough were enrolled. 138 patients (47.2%) developed postoperative cough, univariate and multivariate logistic regression analysis were performed to identify the independent risk factors of postoperative cough. For an exploratory analysis, patients with cough were divided into low and high- FENO [≥ 31 parts per billion (ppb)] groups. The LCQ-CM was used to evaluate changes and recovery trajectory of postoperative cough over time between the two groups for 12 months after surgery. Results The independent factors of postoperative cough included preoperative FENO level [odds ratio (OR) 1.106, 95% confidence interval (CI): 1.076–1.137, p < 0.001] and duration of anesthesia (OR 1.008, 95% CI: 1.002–1.013, p = 0.004). The low-FENO group reported significantly higher LCQ-MC scores at 1 month after surgery and returned to preoperative physical (28 vs. 91 days), psychological (28 vs. 60 days), social (28 vs. 80 days) and total (28 vs. 91 days) scores faster than the high-FENO group (all p < 0.05). Conclusion Higher preoperative FENO level and longer duration of anesthesia were independent risk factors related to postoperative cough. Additionally, patients with high preoperative FENO level had worse cough-related quality of life and slower recovery from postoperative cough. Trial Registration This study was approved by the Chinese Clinical Trial Registry (Clinicaltrials.gov number: ChiCTR1900023419) on 26 May 2019 and the first patient was enrolled after pre-registration. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-024-03413-y.

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Perioperative changes in exhaled nitric oxide during oesophagectomy

Cited by 3 publications

References 24 publications

PEAK End-Tidal NO as a biomarker for investigating the effect of different OLV strategies on lung injury and inflammation response.

PEAK End-Tidal NO as a biomarker for investigating the effect of different OLV strategies on lung injury and inflammation response.

Perioperative Exhaled Nitric Oxide as an Indicator for Postoperative Pneumonia in Surgical Lung Cancer Patients: A Prospective Cohort Study Based on 183 Cases

Preoperative fractional exhaled nitric oxide is a risk and predictive factor of postoperative cough for early-stage non-small cell lung cancer patients: a longitudinal study

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