Comparison of Exhaled and Serum Nitric Oxide Levels

描述(申请人提供)：呼出的一氧化氮(NO)作为肺部炎症和氧化应激的非侵入性标志物越来越受到人们的关注。以往的研究主要集中在使用呼出的NO来诊断和监测自主呼吸患者的呼吸道炎症。然而，很少有研究涉及机械通气(MV)患者。机械通气过程中的呼吸道炎症和氧化应激倾向于更严重的并发症，如急性肺损伤。因此，NO分析在MV患者中也可能有潜在的用途。作为第一步，有必要探讨呼出的NO及其血清标志物(血清亚硝酸盐[SnO2-])水平随时间的变化，这些患者需要人工气道(扰乱正常的NO从鼻子到下呼吸道的流动)和MV(引入混杂因素)。本研究旨在观察两组患者鼻腔呼出NO(NNO)、下呼吸道呼出NO(LNO)及SnO2-随时间的变化：1)气管切开或喉切除患者(T/L)；2)MV中气管切开(T-MV)患者。将采用前瞻性的2x3重复测量设计。对T/L组、L组、T/L组、气管切开前、气管切开后1~3天、气管切开后1周的NO、LNO、SnO2进行比较。统计分析将包括描述性统计、2x3重复测量MANCOVA、单向重复测量ANOVA和Sperman等级相关。

DESCRIPTION (provided by applicant): There is a growing interest in exhaled nitric oxide (NO) as a non-invasive marker of pulmonary inflammation and oxidative stress. Previous studies has focused on use of exhaled NO to diagnose and monitor the airway inflammation in spontaneously breathing patients. However, few studies have involved mechanically ventilated (MV) patients. Airway inflammation and oxidative stress during MV tend to predispose to more serious complications, such as acute lung injury. Thus exhaled NO analysis may also have a potential use in MV patients. As an initial step, it is necessary to explore changes in levels of exhaled NO and its serum marker (serum nitrite [sNO2- ]) over time in patients who require an artificial airway (which disrupts normal NO flow from the nose to the lower airways) and MV (which introduces confounding factors). The purpose of this study is to examine changes in exhaled NO from the nose (nNO), exhaled NO from the lower airways (LNO) and sNO2- over time in: 1) spontaneously breathing patients undergoing tracheostomy or laryngectomy (T/L), and 2) patients undergoing tracheostomy while on MV (T-MV). A prospective, 2x3 repeated measures design will be used. Comparisons will be made between nNO, LNO and sNO2- obtained 1) pre-T/L, Day 1-3 post-T/L, and 1 week after in T/L patients, and 2) pre-tracheostomy, Day 1-3 post-tracheostomy, and 1 week after in T-MV patients. Statistical analysis will include descriptive statistics, 2x3 repeated measures MANCOVA, 1 way repeated measures ANOVA and Sperman's rank correlation.