Effect of mannitol dry powder challenge on exhaled nitric oxide in children.

<h4>Background</h4>Fractional exhaled nitric oxide (FENO), a non-invasive marker of eosinophilic airway inflammation, is increasingly used for diagnostic and therapeutic decisions in adult and paediatric asthma. Standardized guidelines for the measurement of FENO recommend performing FEN...

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Autores principales:	Juerg Barben, Marie-Pierre F Strippoli, Daniel Trachsel, Barbara Schiller, Juerg Hammer, Claudia E Kuehni
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e774363d67d441dea6b1644f05c63c56
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spelling	oai:doaj.org-article:e774363d67d441dea6b1644f05c63c562021-11-18T08:00:50ZEffect of mannitol dry powder challenge on exhaled nitric oxide in children.1932-620310.1371/journal.pone.0054521https://doaj.org/article/e774363d67d441dea6b1644f05c63c562013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23349918/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Fractional exhaled nitric oxide (FENO), a non-invasive marker of eosinophilic airway inflammation, is increasingly used for diagnostic and therapeutic decisions in adult and paediatric asthma. Standardized guidelines for the measurement of FENO recommend performing FENO measurements before rather than after bronchial provocation tests.<h4>Objective</h4>To investigate whether FENO levels decrease after a Mannitol dry powder (MDP) challenge in a clinical setting, and whether the extent of the decrease is influenced by number of MDP manoeuvres, baseline FENO, atopy and doctor diagnosed asthma.<h4>Methods</h4>Children aged 6-16 years, referred for possible reactive airway disease to a respiratory outpatient clinic, performed an MDP challenge (Aridol®, Pharmaxis, Australia). FENO was measured in doublets immediately before and after the challenge test using the portable NIOX MINO® device (Aerocrine, Stockholm, Sweden). We analysed the data using Kruskal-Wallis rank tests, Wilcoxon signed rank tests and multivariable linear regressions.<h4>Results</h4>One hundred and seven children completed both tests (mean±SD age 11.5±2.8 years). Overall, median (interquartile range) FENO decreased slightly by -2.5 ppb (-7.0, -0.5), from 18.5 ppb (10.5, 45.5) before the MDP challenge to 16.5 ppb thereafter (8.5, 40.5; p<0.001). In all participants, the change in FENO was smaller than one standard deviation of the baseline mean. The % fall in FENO was smaller in children with less MDP manoeuvres (e.g. higher bronchial responsiveness; p = 0.08) but was not influenced by levels of baseline FENO (p = 0.68), atopy (p = 0.84) or doctor diagnosed asthma (p = 0.93).<h4>Conclusion</h4>MDP challenge test influences FENO values but differences are small and clinically barely relevant.Juerg BarbenMarie-Pierre F StrippoliDaniel TrachselBarbara SchillerJuerg HammerClaudia E KuehniPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 1, p e54521 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juerg Barben Marie-Pierre F Strippoli Daniel Trachsel Barbara Schiller Juerg Hammer Claudia E Kuehni Effect of mannitol dry powder challenge on exhaled nitric oxide in children.
description	<h4>Background</h4>Fractional exhaled nitric oxide (FENO), a non-invasive marker of eosinophilic airway inflammation, is increasingly used for diagnostic and therapeutic decisions in adult and paediatric asthma. Standardized guidelines for the measurement of FENO recommend performing FENO measurements before rather than after bronchial provocation tests.<h4>Objective</h4>To investigate whether FENO levels decrease after a Mannitol dry powder (MDP) challenge in a clinical setting, and whether the extent of the decrease is influenced by number of MDP manoeuvres, baseline FENO, atopy and doctor diagnosed asthma.<h4>Methods</h4>Children aged 6-16 years, referred for possible reactive airway disease to a respiratory outpatient clinic, performed an MDP challenge (Aridol®, Pharmaxis, Australia). FENO was measured in doublets immediately before and after the challenge test using the portable NIOX MINO® device (Aerocrine, Stockholm, Sweden). We analysed the data using Kruskal-Wallis rank tests, Wilcoxon signed rank tests and multivariable linear regressions.<h4>Results</h4>One hundred and seven children completed both tests (mean±SD age 11.5±2.8 years). Overall, median (interquartile range) FENO decreased slightly by -2.5 ppb (-7.0, -0.5), from 18.5 ppb (10.5, 45.5) before the MDP challenge to 16.5 ppb thereafter (8.5, 40.5; p<0.001). In all participants, the change in FENO was smaller than one standard deviation of the baseline mean. The % fall in FENO was smaller in children with less MDP manoeuvres (e.g. higher bronchial responsiveness; p = 0.08) but was not influenced by levels of baseline FENO (p = 0.68), atopy (p = 0.84) or doctor diagnosed asthma (p = 0.93).<h4>Conclusion</h4>MDP challenge test influences FENO values but differences are small and clinically barely relevant.
format	article
author	Juerg Barben Marie-Pierre F Strippoli Daniel Trachsel Barbara Schiller Juerg Hammer Claudia E Kuehni
author_facet	Juerg Barben Marie-Pierre F Strippoli Daniel Trachsel Barbara Schiller Juerg Hammer Claudia E Kuehni
author_sort	Juerg Barben
title	Effect of mannitol dry powder challenge on exhaled nitric oxide in children.
title_short	Effect of mannitol dry powder challenge on exhaled nitric oxide in children.
title_full	Effect of mannitol dry powder challenge on exhaled nitric oxide in children.
title_fullStr	Effect of mannitol dry powder challenge on exhaled nitric oxide in children.
title_full_unstemmed	Effect of mannitol dry powder challenge on exhaled nitric oxide in children.
title_sort	effect of mannitol dry powder challenge on exhaled nitric oxide in children.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/e774363d67d441dea6b1644f05c63c56
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Effect of mannitol dry powder challenge on exhaled nitric oxide in children.

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