Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Fractional exhaled nitric oxide and forced expiratory flow between 25% and 75% of vital capacity in children with controlled asthma

  • Yoon, Ji-Yong (Department of Pediatrics, Medical Research Institute, Chungbuk National University College of Medicine) ;
  • Woo, Sung-Il (Department of Pediatrics, Medical Research Institute, Chungbuk National University College of Medicine) ;
  • Kim, Heon (Department of Preventive Medicine, Medical Research Institute, Chungbuk National University College of Medicine) ;
  • Sun, Yong-Han (Department of Pediatrics, Medical Research Institute, Chungbuk National University College of Medicine) ;
  • Hahn, Youn-Soo (Department of Pediatrics, Medical Research Institute, Chungbuk National University College of Medicine)
  • Received : 2011.12.01
  • Accepted : 2012.03.23
  • Published : 2012.09.15
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Abstract

Purpose: Fractional exhaled nitric oxide (FeNO) and forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25-75}$) are not included in routine monitoring of asthma control. We observed changes in FeNO level and $FEF_{25-75}$ after FeNO-based treatment with inhaled corticosteroid (ICS) in children with controlled asthma (CA). Methods: We recruited 148 children with asthma (age, 8 to 16 years) who had maintained asthma control and normal forced expiratory volume in the first second ($FEV_1$) without control medication for ${\geq}3$ months. Patients with FeNO levels >25 ppb were allocated to the ICS-treated (FeNO-based management) or untreated group (guideline-based management). Changes in spirometric values and FeNO levels from baseline were evaluated after 6 weeks. Results: Ninety-three patients had FeNO levels >25 ppb. These patients had lower $FEF_{25-75}$ % predicted values than those with FeNO levels ${\leq}25$ ppb (P<0.01). After 6 weeks, the geometric mean (GM) FeNO level in the ICS-treated group was 45% lower than the baseline value, and the mean percent increase in $FEF_{25-75}$ was 18.7% which was greater than that in other spirometric values. There was a negative correlation between percent changes in $FEF_{25-75}$ and FeNO (r=-0.368, P=0.001). In contrast, the GM FeNO and spirometric values were not significantly different from the baseline values in the untreated group. Conclusion: The anti-inflammatory treatment simultaneously improved the FeNO levels and $FEF_{25-75}$ in CA patients when their FeNO levels were >25 ppb.

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References

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