Exhaled nitric oxide increases following admission for intravenous antibiotics in children with cystic fibrosis.
BACKGROUND
Lack of standardisation for the measurement of exhaled nitric oxide (NO) (FENO) has resulted in conflicting data in cystic fibrosis (CF). The aim of this study was to assess whether FENO is a useful non-invasive marker of lung disease in CF by assessing the effect of intravenous (IV) antibiotics on FENO.


METHODS
FENO was measured on line, according to recently published ERS/ATS guidelines, using a chemiluminescence analyser together with pulmonary function in 14 CF children prior to and following a course of IV antibiotics.


RESULTS
There was a significant improvement in mean (S.E.M.) % FEV1 from 60.0 (6.3) to 68.0 (5.4) (P < 0.05) and mean (S.E.M.) % FVC from 66.3 (5.5) to 75.1 (4.9) (P < 0.01). FENO increased significantly from median (range) 5.8 (2.0-14.3) to 9.2 ppb (0.8-25.1) (P < 0.05). There was no correlation between FE(NO) and lung function. Subgroup analysis on those with chronic Pseudomonas aeruginosa infection (n = 6) demonstrated no significant change in FENO.


CONCLUSIONS
Using a flow of 50 ml/s, FENO increases following admission for IV antibiotic treatment in children with CF but does not correlate with lung function. It is not a useful marker of lung diseases in CF, which has implications for clinical practice.
Portex Respiratory Medicine Unit, Great Ormond Street Hospital for Children NHS Trust and Institute of Child Health, Great Ormond Street, London WC1N 3JH, UK. a.jaffe@ich.ucl.ac.uk
Adam
A
Jaffé
Gail
G
Slade
John
J
Rae
Aidan
A
Laverty
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000378:metabolism* / Q000382:microbiology; D045853:Exhalation; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008163:Luminescent Measurements; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D012129:Respiratory Function Tests; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents; D009569:Nitric Oxide