title: A flow- and pressure-controlled offline method of exhaled nitric oxide measurement in children.
abstract: BACKGROUND
  Exhaled nitric oxide (eNO) is a noninvasive marker of airway inflammation. However, previous studies show that the offline value is lower than the online value.
  
  
  OBJECTIVE
  To compare a standard offline eNO measurement apparatus with a modified apparatus that can monitor flow volume and respiratory pressure.
  
  
  METHODS
  We studied 73 cooperative individuals aged 5 to 28 years (32 children: mean age, 8.3 years; 41 adults: mean age, 21.5 years). We modified the standard device by including a flow meter with a manometer and attaching a plastic tube connected to a 3-way valve to control the resistance. The online and offline (measured using the modified device and the standard device) eNO determinations were compared in a single session and were analyzed using a nitric oxide analyzer.
  
  
  RESULTS
  There was a good relationship between the online and modified offline eNO measurements in children. The modified offline method showed a stronger correlation with the online method (r = .97 vs. r = .92), and the modified offline eNO value was more similar to the online eNO value than to the standard offline value. The mean difference between the online and standard offline eNO values was 52%, whereas the mean difference between the online and modified offline eNO values was only 10%.
  
  
  CONCLUSIONS
  Using the offline method, we can easily control the resistance and flow volume to reach the same value measured by the online method in childhood respiratory diseases.
authors.affiliation: Department of Pediatrics and Developmental Medicine, Gunma University Graduate School of Medicine, Gunma, Japan. hiromic@pop06.odn.ne.jp
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tadaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mochizuki
authors.forename: Reiko
authors.initials: R
authors.lastname: Muramastu
authors.forename: Satomi
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Takahisa
authors.initials: T
authors.lastname: Mizuno
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Arakawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morikawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000403:Airway Resistance / Q000502:physiology; D001249:Asthma / Q000378:metabolism*; D001944:Breath Tests / Q000295:instrumentation / Q000379:methods; D002648:Child; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis* / Q000378:metabolism
chemical_list: D009569:Nitric Oxide