Exhaled nitric oxide monitoring in COPD using a portable analyzer.
BACKGROUND
The exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation in asthma. A very recent statement has suggested FeNO as potential outcome in chronic obstructive pulmonary disease (COPD). Recently, a new hand-held FeNO analyzer (NIOX MINO) has been developed.


METHODS
We have evaluated the NIOX MINO in COPD patients and monitored FeNO levels during 1-year assessment in the outpatient setting. Short-term variability in FeNO was compared using a NIOX MINO and a stationary chemiluminescence analyzer (NOA, Sensormedics) in healthy volunteers and COPD patients on two consecutive months. Long-term FeNO variability was assessed on a cohort of 70 COPD outpatients measuring FeNO for 1 year. The intra-individual FeNO coefficient of variation (eNOCoV) was taken as index FeNO long-term variability.


RESULTS
In COPD there were no significant differences between NIOX MINO and NOA FeNO values recorded at baseline and 1 month later. Ninety five percent limits of agreement between NIOX MINO and NOA were-2.7 and 1.9ppb with significant reliability (r=0.96, p<0.0001). Mean FeNO at baseline was 15.0+/-9.5ppb. Over the 1-year period the overall mean FeNO was 15.5+/-10.1ppb. The long-term eNOCoV was 33.9+/-16.4% (range 8.1-83.1%), and it was significantly associated with exacerbation rate (r=0.57, p<0.0001).


CONCLUSIONS
FeNO electrochemical hand-held analyzer is feasible in COPD showing good agreement with stationary chemiluminescence analyzer. COPD patients exhibit a wide range of FeNO levels and a high variability of FeNO over time, which was positively associated with the number of exacerbations.
Department of Respiratory Diseases, University "Federico II", Naples, Italy; Department of Pulmonary Diseases, Second University of Naples, Italy.
Guglielmo
G
de Laurentiis
Mauro
M
Maniscalco
Flavia
F
Cianciulli
Anna
A
Stanziola
Serafino
S
Marsico
Jon O
JO
Lundberg
Eddie
E
Weitzberg
Matteo
M
Sofia
D000368:Aged; D000553:Ambulatory Care; D001944:Breath Tests / Q000295:instrumentation* / Q000379:methods; D015331:Cohort Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008163:Luminescent Measurements / Q000379:methods; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis* / Q000378:metabolism; D029424:Pulmonary Disease, Chronic Obstructive / Q000378:metabolism*; D015203:Reproducibility of Results; D013997:Time Factors
D009569:Nitric Oxide