title: The value of exhaled nitric oxide in predicting bronchial hyperresponsiveness in children.
abstract: Reduced attention span and motor skills in children limit the practicability of bronchial provocation tests. To assess exhaled nitric oxide (FeNO) as a surrogate for bronchial hyperresponsiveness (BHR) in children with possible reactive airway disease, FeNO was measured using the single-breath method in 169 successive outpatients 11 +/- 5 years of age before lung function testing and subsequent bronchial provocation by exercise (n = 165) and methacholine (n = 134). Baseline forced expiratory volume in 1 second (FEV(1)) less than 80% of predicted and/or BHR were seen in 59%. FeNO correlated weakly with PD(20) to methacholine (r = -0.24, p < 0.05), but not with the change in FEV(1) due to exercise-induced bronchoconstriction (EIB) (r = 0.1, p > 0.05). The negative predictive value of FeNO less than 10 ppb for EIB was 94%, but overall accuracy for predicting BHR was low. Measurement of FeNO is not a substitute for bronchial provocation in children.
authors.affiliation: Division of Pediatric Intensive Care and Pulmonology, University Children's Hospital of Basel, Basel, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Ramser
authors.forename: Juerg
authors.initials: J
authors.lastname: Hammer
authors.forename: Arnold
authors.initials: A
authors.lastname: Amacher
authors.forename: Daniel
authors.initials: D
authors.lastname: Trachsel
mesh_terms: D000293:Adolescent; D016535:Bronchial Hyperreactivity / Q000175:diagnosis* / Q000378:metabolism* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D002648:Child; D005080:Exercise Test; D045853:Exhalation; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D016210:Methacholine Chloride; D009569:Nitric Oxide / Q000378:metabolism*; D010993:Plethysmography, Whole Body; D011237:Predictive Value of Tests; D013147:Spirometry
chemical_list: D016210:Methacholine Chloride; D009569:Nitric Oxide