Measurement of nasal nitric oxide in children – first experiences


Authors: G. Bugová 1;  B. Uhliarová 2;  P. Ďurdík 3;  A. Hajtman 1;  M. Jeseňák 3
Authors‘ workplace: Klinika ORL a ChHaK UK JLF a UNM, Martin prednosta prof. MUDr. A. Hajtman, PhD. 1;  ORL oddelenie, FNsP F. D. Roosevelta, Banská Bystrica primár MUDr. M. Švec 2;  Klinika detí a dorastu UK JLF a UNM, Martin prednosta prof. MUDr. P. Bánovčin, CSc. 3
Published in: Čes-slov Pediat 2016; 71 (2): 68-75.
Category: Original Papers

Overview

Introduction:
In the respiratory system, nitric oxide (NO) acts as a neurotransmitter of nonadrenergic non-cholinergic mediation and significantly participates in the regulation of physiological functions. NO has important effect on the smooth muscles, blood vessels and bronchi. Nitric oxide diffuses into the lumen of the respiratory system and subsequently can be measured by sensitive detector. The importance of measurements of NO levels has been confirmed in the diagnosis as well as management of patients with bronchial asthma. Nowadays, attention is focused on the determination of nasal nitric oxide (nNO). Evaluation of nNO is not standardized and its clinical significance and possible application in clinical practice have not been determined.

Methods:
The prospective study was conducted with 60 children that were scheduled to endoscopic adenotomy for adenoid vegetation at the Department of Otorhinolaryngology, Head and Neck Surgery, Comenius University, Jessenius Faculty of Medicine, University Hospital in Martin, Slovakia. Concentration of nNO was measured and differences in the levels of nNO according to the age, sex, size of adenoid tissue, presence of atopy and pathogens in the upper airways were evaluated.

Results:
The mean concentration of nNO was 337±36 ppb. There were significantly lower levels of nNO in younger children (≤5 years) compared to older ones (P<0.05). Identification of pathogens in nasopharynx was associated with significantly higher levels of nNO (P<0.05). Differences in concentration of nNO according to the sex, side of the nasal cavity, size of adenoid tissue and presence of atopy were not observed (P>0.05).

Conclusion:
It is possible to measure nasal nitric oxid also in very young children. Measurement of nNO is non-invasive method that can contribute to the diagnosis of diseases of the upper and lower respiratory tract. Changes in nNO may indicate obstruction and inflammation of the upper airways.

Key words:
nitric oxide, upper airways, adenoid vegetation, pathogenic bacteria


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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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