Exhaled nitric oxide in acute exacerbation of pediatric asthma
AbstractBackground Measurement of exhaled nitric oxide (eNO) is a non-
invasive and easy method to monitor airway inflammation.
Objectives To compare the levels of eNO during and after an
exacerbation of asthma, to evaluate the effect of glucocor-
ticosteroids (GCS) on the levels of eNO and to correlate eNO
with other markers of inflammation such as symptom scores, FEV 1
and sputum eosinophils.
Methods The observational study was performed over 24 months
at a tertiary paediatric hospital. Subjects underwent eNO
measurement, spirometry and sputum induction during an asthma
exacerbation and then two weeks later. A symptom score was
recorded everyday for two weeks. All subjects were treated with
ÃŸ 2 -adrenergic agonists and an oral glucocorticosteroid (GCS).
Results Fifteen subjects with acute asthma exacerbation aged 5
and 16 years old participated in the study. The mean level of
eNO during the acute exacerbation was significantly higher than
eNO levels at the follow-up visit, 11.2 (95%CI 9.2;13.2) vs. 8.0
(95%CI 5.0;11.1) ppb, P=0.03. In the acute exacerbation, eNO
correlated with sputum eosinophils (P=0.04), but no correlation
could be found between eNO and the other markers of
inflammation during exacerbation or follow up.
Conclusions eNO level increased during asthma exacerbation and
decreased after two weeks of glucocorticosteroid therapy.
Measurement of eNO is a practical monitoring method in
emergency management of asthmatic children.
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