Arch. argent. pediatr. vol.111 no.3 Buenos Aires June 2013
http://dx.doi.org/10.5546/aap.2013.191
ORIGINAL ARTICLE
Association between the Asthma Predictive Index and levels of exhaled nitric oxide in infants and toddlers with recurrent wheezing
Juan Emilio Balinotti, M.D.a, Alejandro Colom, M.D.a, Carlos Kofman, M.D.a and Alejandro Teper, M.D.a
a. Respiratory Center Dr. Alberto R.Álvarez. Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina.
E-mail address: Juan Emilio Balinotti, M.D., juanbalinotti@gmail.com
Funding: This study was conducted with the support of an annual fellowship grant called the Florencio Fiorini Medical Research Stimulation, year 2009, granted by the Fundación Florencio Fiorini and the Asociación MédicaArgentina.
Conflict of interest: None.
Received: 10-29-2012
Accepted: 1-18-2013
Accepted: 1-18-2013
ABSTRACT
It is difficult to make an early identification of which children with recurrent wheezing will develop asthma in the following years. The Asthma Predictive Index (API) is a questionnaire based on clinical and laboratory parameters used for this end. The measurement of fractional exhaled nitric oxide (FENO) has been used as a marker of eosinophilic airway infammation in asthma patients.
Objective. To determine the association between the Asthma Predictive Index and FENO levels in children younger than 3 years old with recurrent wheezing.
Materials and methods. Observational, cross sectional study. Children younger than 36 months old with 3 or more episodes of bronchial obstruction in the past year who were inhaled corticosteroid-naive or leukotriene receptor antagonist-naive were included. After recording clinical data, FENO was measured by a chemiluminescence analyzer during tidal breathing (online method).
Results. A total of 52 children aged 5-36 months old were included. Patients with a positive API accounted for 60% of the population and had higher levels of FENO than those with a negative API, with a median (range) of 13.5 ppb (0.7-31) versus 5.6 ppb (0.1-20.8), respectively (p - 0.01). A high FENO (+ 8 ppb) was observed in 74% of children with a positive API and in 26% of those with a negative API (p - 0.01).
Conclusions. This study found an association between high levels of exhaled nitric oxide and a positive Asthma Predictive Index in children younger than 3 years old with recurrent wheezing.
Objective. To determine the association between the Asthma Predictive Index and FENO levels in children younger than 3 years old with recurrent wheezing.
Materials and methods. Observational, cross sectional study. Children younger than 36 months old with 3 or more episodes of bronchial obstruction in the past year who were inhaled corticosteroid-naive or leukotriene receptor antagonist-naive were included. After recording clinical data, FENO was measured by a chemiluminescence analyzer during tidal breathing (online method).
Results. A total of 52 children aged 5-36 months old were included. Patients with a positive API accounted for 60% of the population and had higher levels of FENO than those with a negative API, with a median (range) of 13.5 ppb (0.7-31) versus 5.6 ppb (0.1-20.8), respectively (p - 0.01). A high FENO (+ 8 ppb) was observed in 74% of children with a positive API and in 26% of those with a negative API (p - 0.01).
Conclusions. This study found an association between high levels of exhaled nitric oxide and a positive Asthma Predictive Index in children younger than 3 years old with recurrent wheezing.
Key words: Asthma predictive algorithm; Exhaled nitric oxide; Recurrent wheezing; Infants and toddlers.
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