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Exhaled nitric oxide levels during treatment in patients hospitalized with asthma

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The time required for fractional excretion of nitric oxide (FENO) measurements to acutely change after systemic corticosteroids is unknown, limiting the usefulness of this biomarker in hospital treatment and discharge decisions. The purpose of this study was to follow FENO measurements of hospitalized adult patients with asthma receiving therapy and to correlate FENO with forced expiratory volume in 1 second percent predicted (FEV1%). Ten acute asthmatic patients who required hospitalization were recruited and treated with standard therapy. FENO measurements were performed at presentation to the emergency department (baseline), as well as 1, 4, 6, 8, 12, and 24 hours after the initiation of therapy. FEV1% was measured at baseline, 1, 6, 12, and 24 hours. Subjects also were called 3 days after discharge to assess if symptoms had improved. The baseline FENO was 57.5 parts per billion (ppb). There was no significant change over the first 8 hours. At 12 hours, there was an increase to 96.5 ppb (p = 0.01). Compared with baseline, all 10 subjects showed an increase at the 12-hour time point, with an average increase of 52%. The correlation between change in FENO and change in FEV1% approached significance (p = 0.089). Subjects who improved after discharge had a greater percent increase in FENO than those who did not (p = 0.043). FENO measurements increase in hospitalized asthmatic patients receiving therapy. This augmentation appears to be associated with improvements in FEV1. Asthmatic patients who show a greater increase in FENO may have better outcomes after discharge.
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Keywords: Asthma; asthma exacerbation; breath tests; corticosteroids; hospitalization; nitric oxide; relapse; respiratory function tests; spirometry; treatment outcome

Document Type: Research Article

Affiliations: 1: Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan 2: Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, Michigan

Publication date: 2008-03-01

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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