PubMed · 14377774
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A DE MARIA. [A pulmonary function test].. https://pubmed.ncbi.nlm.nih.gov/14377774/
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Exhaled nitric oxide (FENO) may provide a tool for identifying infants at risk of developing allergic disease in childhood. In infants there is no standardized collection technique; however, the easiest method is to measure FENO during tidal breathing. In this study we investigated various methodological issues for tidal breathing (TB) FENO in infants. These included the effect of ambient NO, oral or nasal breathing, sedation, and tidal expiratory flow. Furthermore, we compared TB FENO in 88 infants with and without wheeze. Ambient NO greater than 5 ppb significantly affected FENO. There was no significant difference between NO levels measured during either oral or nasal breathing; however, there was a significant difference between levels collected from infants before and after sedation (P < 0.001). Tidal breathing FENO decreased with increasing tidal flows (P < 0.001) and increased with age (P = 0.002). There was no significant difference in mixed expired NO between healthy and wheezy children, but children with doctor-diagnosed eczema had significantly raised levels (P = 0.014). There seem to be important methodological limitations for measuring FENO in infants during TB.
PURPOSE OF REVIEW: Since the first description of nitric oxide in the exhaled breath of humans by Gustafsson et al., there has been enormous interest in the study of nitric oxide and its role in the nose and paranasal sinuses. The aim of this review is to present the current knowledge about nasal NO: its physiology, novel methods of detection and measurement, and implications in sinonasal disease, focusing on the recent data from the literature. RECENT FINDINGS: Nitric oxide production is known to be produced in the nose at the apical tip of the ciliated respiratory mucosa. A new study has localized nitric oxide production in the pericytes and osteocytes of nasal turbinates. Studies have also discovered the efficacy of offline measurement techniques showing high correlation between standard online measurements with offline techniques. In an interesting study examining the influence of maxillary ostium size and nasal nitric oxide levels, decreased nitric oxide levels found with larger size ostia may eventually influence our approach to sinus surgery. SUMMARY: Nasal nitric oxide has been an ever-increasing topic of interest to both the allergist and the head and neck surgeon. The recent advances in the study of nasal nitric oxide as it relates to sinonasal disease and nasal physiology are discussed and important new findings are highlighted.