Exhaled nitric oxide levels during treatment of pediatric acute asthma exacerbations and association with the need for hospitalization.
Exhaled nitric oxide levels during treatment of pediatric acute asthma exacerbations and association with the need for hospitalization.
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DOI：
10.1097/pec.0b013e318212a4fa
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发表时间：
2011-04
影响因子：
1.4
通讯作者：
Strunk RC
中科院分区：
文献类型：
--
作者：
Nelson KA;Lee P;Trinkaus K;Strunk RC
目的：探讨如何呼出一氧化氮（eNO）水平测量哮喘急性发作治疗前后与急诊科（艾德）disposition.Methods：我们招募了6至17岁的儿童哮喘急性发作治疗的儿科ED。使用离线单呼吸eNO采样技术，我们收集了重复的初始样本治疗前和重复的最终样本时，处置决定。我们确定了相关性和变异系数的eNO值（十亿分之一，ppb）的样品和处置（住院或出院）的平均初始和最终eNO水平和初始到最终的change.Results：81名受试者的初始和最终eNO值比较; 24名受试者更严重的介绍了最终值。重复eNO样本相关（初始r= 0.98，最终r= 0.99），变异系数较低（初始，0.059±0.057;最终，0.061±0.070）。对于具有初始值和最终值的受试者，初始eNO水平按分布相似（平均差异，− 8.0 ppb; 95%置信区间[CI]，− 24.8至8.9 ppb），最终水平也相似（平均差异，− 2.8 ppb; 95% CI，− 23.8至18.2 ppb）。总体而言，最终eNO高于初始（36.3±29.7 vs 31.5±23.9 ppb），但仅63%的受试者出现任何增加。不同处置的eNO变化相似（平均差异，4.6 ppb; 95% CI，-3.4至12.6）。对于更严重的受试者与最终eNO只有，eNO是相似的处置（P= 0.47）。结论：对于6至17岁的儿童哮喘急性发作，eNO水平可以可靠地测量。然而，治疗前或确定处置时测量的eNO水平并不能区分需要住院的儿童。
Objectives:To examine how exhaled nitric oxide (eNO) levels measured before and after treatment of asthma exacerbations relate to emergency department (ED) disposition.Methods:We enrolled children 6 to 17 years old treated for asthma exacerbations in a pediatric ED. Using an offline single-breath eNO sampling technique, we collected replicate initial samples before treatment and replicate final samples when disposition was decided. We determined correlations and coefficients of variability of eNO values (parts per billion, ppb) of samples and compared by disposition (hospitalization or discharge) mean initial and final eNO levels and initial-to-final change.Results:Eighty-one subjects had initial and final eNO values; 24 subjects with more severe presentations had final values only. Replicate eNO samples were correlated (initial r= 0.98, final r= 0.99) and had low coefficients of variability (initial, 0.059±0.057; final, 0.061±0.070). For subjects with initial and final values, initial eNO levels were similar by disposition (mean difference,− 8.0 ppb; 95% confidence interval [CI],− 24.8 to 8.9 ppb), as were final levels (mean difference,− 2.8 ppb; 95% CI,− 23.8 to 18.2 ppb). Overall, final eNO was higher than initial (36.3±29.7 vs 31.5±23.9 ppb), but only 63% of subjects had any increase. Change in eNO was similar by disposition (mean difference, 4.6 ppb; 95% CI,− 3.4 to 12.6). For more severe subjects with final eNO only, eNO was similar by disposition (P= 0.47).Conclusions:For children aged 6 to 17 years with asthma exacerbations, eNO levels can be reliably measured. However, eNO levels measured before treatment or when disposition was determined did not distinguish children needing hospitalization.