Feasibility of nasal NO screening in healthy newborns.
chemoluminescence
electrochemical sensor
nasal nitric oxide
newborns
primary ciliary dyskinesia
screening
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
10
09
2021
received:
20
10
2020
accepted:
20
09
2021
pubmed:
28
9
2021
medline:
4
1
2022
entrez:
27
9
2021
Statut:
ppublish
Résumé
Nasal nitric oxide (nNO) measurement is recommended as a first line screening test for primary ciliary dyskinesia (PCD). While reliable velum- and non-velum-closure techniques exist for preschool children and older individuals, no data are available for neonates. To determine feasibility of nNO screening and nNO concentration in healthy newborns in the first week of life. Nasal NO was analyzed in tidal breathing during natural sleep using a CLD-88 sp NO analyzer (chemoluminescence sensor) and a NIOX MINO (electrochemical sensor). Test success and nNO concentration were determined and compared between the two devices. Nasal NO was measured in 62 healthy neonates within the first week of life. Feasibility of nNO measurement was 100% for at least one nostril and 85.5% for both nostrils using the chemoluminescence device, but significantly lower with the electrochemical device (85.5% and 53.2%; p < .001). Median nNO concentration was 38 ppb (interquartile range, 27-55; range, 9-100) with the ECOMEDICS device and 23 (15-33, 8-59) with the NIOX MINO (p < .001), with a trend towards higher values for older subjects. None of the subjects exceeded nNO levels of 100 ppb. Measurement of nNO using a chemoluminescence device is highly feasible in newborns during natural sleep. However, nNO levels are considerably lower compared to the published data for older individuals and in the range of a PCD reference group of infants between 4 and 8 weeks of age, potentially resulting in a great overlap with subjects with PCD in this age group. Therefore, screening for PCD using nasal NO might not be useful in the first week of life. Upon clinical suspicion, other diagnostic tests such as high-speed video analysis of the cilia should be applied.
Sections du résumé
BACKGROUND
Nasal nitric oxide (nNO) measurement is recommended as a first line screening test for primary ciliary dyskinesia (PCD). While reliable velum- and non-velum-closure techniques exist for preschool children and older individuals, no data are available for neonates.
AIMS
To determine feasibility of nNO screening and nNO concentration in healthy newborns in the first week of life.
METHODS
Nasal NO was analyzed in tidal breathing during natural sleep using a CLD-88 sp NO analyzer (chemoluminescence sensor) and a NIOX MINO (electrochemical sensor). Test success and nNO concentration were determined and compared between the two devices.
RESULTS
Nasal NO was measured in 62 healthy neonates within the first week of life. Feasibility of nNO measurement was 100% for at least one nostril and 85.5% for both nostrils using the chemoluminescence device, but significantly lower with the electrochemical device (85.5% and 53.2%; p < .001). Median nNO concentration was 38 ppb (interquartile range, 27-55; range, 9-100) with the ECOMEDICS device and 23 (15-33, 8-59) with the NIOX MINO (p < .001), with a trend towards higher values for older subjects. None of the subjects exceeded nNO levels of 100 ppb.
CONCLUSION
Measurement of nNO using a chemoluminescence device is highly feasible in newborns during natural sleep. However, nNO levels are considerably lower compared to the published data for older individuals and in the range of a PCD reference group of infants between 4 and 8 weeks of age, potentially resulting in a great overlap with subjects with PCD in this age group. Therefore, screening for PCD using nasal NO might not be useful in the first week of life. Upon clinical suspicion, other diagnostic tests such as high-speed video analysis of the cilia should be applied.
Identifiants
pubmed: 34570949
doi: 10.1002/ppul.25702
pmc: PMC9292553
doi:
Substances chimiques
Nitric Oxide
31C4KY9ESH
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
231-238Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.
Références
Clin Chest Med. 2016 Sep;37(3):449-61
pubmed: 27514592
Cilia. 2015 Jan 22;4(1):2
pubmed: 25610612
Eur Respir J. 2014 Dec;44(6):1589-99
pubmed: 25323224
Eur Respir J. 2016 Apr;47(4):1103-12
pubmed: 26917608
Pediatr Pulmonol. 2015 Dec;50(12):1374-82
pubmed: 25731630
Eur Respir J. 2018 Jun 21;51(6):
pubmed: 29748307
Eur Respir J. 2009 Dec;34(6):1264-76
pubmed: 19948909
Pediatr Pulmonol. 2022 Jan;57(1):231-238
pubmed: 34570949
Respir Med. 2015 Sep;109(9):1126-30
pubmed: 26233707
Eur Respir J. 2016 Mar;47(3):699-701
pubmed: 26929309
Chest. 2007 Mar;131(3):870-873
pubmed: 17356106
Arch Dis Child Fetal Neonatal Ed. 2006 May;91(3):F233
pubmed: 16632655
J Pediatr. 2011 Sep;159(3):420-4
pubmed: 21514598
PLoS One. 2013;8(2):e57262
pubmed: 23437356
BMC Pulm Med. 2014 Feb 10;14:18
pubmed: 24507708
Eur Respir J. 2010 Dec;36(6):1248-58
pubmed: 20530032
Eur Respir J. 2017 Jan 4;49(1):
pubmed: 27836958
Ann Am Thorac Soc. 2020 Feb;17(2):e1-e12
pubmed: 31770003
Eur Respir J. 2016 Oct;48(4):1096-1107
pubmed: 27492837