Comparison of Exhaled and Serum Nitric Oxide Levels

呼出气一氧化氮（NO）作为肺部炎症的非侵入性标志物越来越受到关注 和氧化应激。以前的研究集中在使用呼出的NO来诊断和监测气道 然而，很少有研究涉及机械通气患者， (MV)患者MV期间的气道炎症和氧化应激倾向于更严重 并发症，如急性肺损伤。因此，呼出NO分析也可能在MV中具有潜在的用途 患者作为一个初步的步骤，有必要探讨呼出气中NO及其血清标志物水平的变化 （血清亚硝酸盐[sNOa”- ]）随时间的变化在需要人工气道的患者中（这会破坏正常的NO流量 从鼻子到下气道）和MV（其引入了混杂因素）。本研究的目的 是检查从鼻子呼出的NO（nNO），从下气道呼出的NO（LNO）和 sNO 2 ~-随时间的变化：1）接受气管造口术或喉切除术（T/L）的自主呼吸患者，以及 2)在MV（T-MV）期间接受气管切开术的患者。前瞻性2x 3重复测量设计将 被利用将在nNO、LNO和sNC>2之间进行比较，1）T/L前，T/L后第1-3天， T/L患者在气管切开前、气管切开后第1-3天和T/L患者在气管切开后1周， T-MV患者。统计分析将包括描述性统计量、2x 3重复测量MANCOVA、1 wav重复测量方差分析和Soearman等级相关。

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 [sNOa"- ]) 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 ariways (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 sNC>2~ 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, one wav repeated measures ANOVA and Soearman's rank correlation.