2013, Number 5
<< Back Next >>
Acta Pediatr Mex 2013; 34 (5)
Measurement of exhaled nitric oxide in children with asthmatic crisis. Systematic review
Meave-Cueva LG,Díaz-García L, LLamosas-Gallardo B, Ortíz-Hernández AA
Language: Spanish
References: 25
Page: 247-252
PDF size: 138.02 Kb.
ABSTRACT
Introduction: The frequency and intensity of symptoms in asthma
are related to the degree of inflammation and bronchial obstruction.
Nitric oxide is a free radical produced at the endothelial
cells of the bronchial wall as an intrinsic part of the inflammatory
process. The exhaled nitric oxide fraction (ENOF) is a marker
that evaluates bronchial inflammation and it is presumed that will
also assess the initial response to treatment, decision making in
terms of hospital discharge and ambulatory monitoring of children
with asthmatic crises.
Material and methods: Systematic review of every publication that
explore the validity of ENOF for the diagnosis of bronchial inflammation
and response to treatment in asthmatic children.
Results: Three of the publications reviewed are designed as
diagnostic tests. Two of them recommend the use of ENOF to
detect bronchial hyper-responsiveness. One cohort recommends
ENOF as a diagnostic tool in suspected asthma; another one
suggests its use to assess the severity of asthma; another one
points that the ENOF is useful to detect relapses. A controlled
clinical trial does not recommend the routine use of ENOF as a
predictor of relapse.
Discussion: No study has been done to assess the usefulness
of the ENOF in children with asthma exacerbation. In regard to
ambulatory control, new publications require a higher level of
evidence with excellent results to encourage pediatricians to
include the measurement of ENOF in the optimal follow-up of
asthmatic children.
REFERENCES
Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Institutes of Health; 1998.
Halfon N, Newacheck PW: Trends in the hospitalization for acute childhood asthma, 1970-84. Am J Public Health. 1996;76:1308-11.
Strachan DP, Anderson HR, Limb ES, O’Neill A, Wells N: A national survey of asthma prevalence, severity, and treatment in Great Britain. Arch Dis Child. 1994;70:174-8.
Departamento de Bioestadistica y archivo clínico. Instituto Nacional de PediatrÍa. 2010.
Vázquez García R, Huerta López José G, Pedroza A, Acosta Bastidas M. Tratamiento de la crisis asmática en niños. Alergia, Asma e Inmunología Pediátricas. 2004;13(3):109-19.
Ceruti E. Asma bronquial. En: Meneghello J, Fanta E, Paris E, Rosselot J, ED. Pediatría.4ª Vol 1. Santiago Chile: Publicaciones Técnicas Mediterráneo Ltd.; 1991. p. 898-996.
Smith SR, Baty JD, Hodge D 3er. Validation of the pulmonary score: An asthma severity score for children. Acad Emerg Med. 2002;9(2):99-104.
McFadden E, Kiser R, DeGroot W. Acute bronchial asthma, relations between clinical and physiologic manifestations. N Engl J Med. 1975;288:221-5.
Smith AD, Cowan JO, Brassett KP, Herbison GP, Taylor DR. Use of Exhaled Nitric Oxide Measurements to Guide Treatment in Chronic Asthma. N Engl J Med 2005;352:2163-73.
Pijnenburg MW, Bakker EM, Hop WC, De Jongste JC. Titrating steroids on exhaled nitric oxide in asthmatic children: a randomized controlled trial. Am J Respir Crit Care Med. 2005;172(7):831-6
Moncada S, Higgs E, Hodson HF, Knowles RG, López-Jaramillo P, McCall T et al. The L-Arginine-nitric oxide pathway. N Engl J Med. 1993;329:2002-12.
Foresti R, Motterlini R. The heme oxigenase pathway and its interaction with nitric oxide in the control of celular homeostasis. Free Radic Res. 1999;31:459-75.
ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide. Am Respir Crit Care Med. 2005;171: 912-30.
National Asthma Education & Prevention Program; Expert Panel report: Guidelines for the Diagnosis and Managment of Asthma. Update on Selected Topics 2002. Bethesda, MD, National Institutes of Health, National Heart, Lung and Blood Institute. 2002.
Childhood Asthma Management Program research Group: Long-term effects of budesonide or nedocromil in children with asthma. N EngL J Med. 2000;343:1054-63.
Pijnenburg MW, Hofhuis W, Hop WC, De Jongste JC. Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission. Thorax. 2005;60:215-8.
Jones SL, Kittelson J, Cowan JO, Flannery EM, Hancox RJ, McLachlan CR et al. The predictive value of exhaled nitric oxide measurements in assessing changes in asthma control. Am J Respir Crit Care Med. 2001;164:738-43.
Beck-Ripp J, Griese M, Arenz S, Koring C, Pasqualoni B, Bufler P. Changes of exhaled nitric oxide during steroid treatment of childhood asthma. Eur Respir J. 2002;19:1015-9.
Alving K, Weitzberg E, Lunberg JM. Increased amount of nitric oxide in exhaled air of asthmatics. Eur Respir J. 1993 6:1268-70.
Kharatinov SA, Yates D, Robbins RA, Logan-Sinclair R, Shinebourne MD. Increased nitric oxide in exhaled air of asthmatics patients. Lancet .1994;343:133-5.
Perpiñá Tordera M, de Diego Damiá A, Compte Torrero L. Aportación del estudio del óxido nítrico en el asma del adulto. Arch Bronconeumol. 2001;37(4):8-14.
Kharitonov SA, Barnes PJ. Clinical aspects of exhaled nitric oxide. Eur J Respir. 2000;162:781-92.
Kharatinov SA. Exhaled nitric oxide and carbon monoxide in asthma. Eur Respir Rev. 1999;68:212-8.
Meave Cueva LG, Ortíz Hernández AA, Llamosas Gallardo B, Diaz García L. Medición del Óxido Nítrico Exhalado en Niños con Crisis Asmática: Revisión Sistemática. Tesis para obtener el título de especialista en urgencias pediátricas. INP-UNAM 2011.
Harris RP, Helfand M, Woolf SH, Lohr KN, Mulrow CD, Teutsch SM, et al. For the Methods Work Group, Third U.S. Preventive Services Task Force. Current Methods of the U.S. Preventive Services Task Force: a review of the process. Am J Prev Med. 2001;20(3S):21-35.