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Copyright ©ERS Journals Ltd 2003
Reproducibility of exhaled nitric oxide measurements in healthy and asthmatic adults and children
Dept of Thoracic Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College of Science, Technology and Medicine, Royal Brompton and Harefield NHS Trust, London, UK
CORRESPONDENCE: S.A. Kharitonov, Dept of Thoracic Medicine, National Heart & Lung Institute, Imperial College, Dovehouse Street, London, SW3 6LY, UK. Fax: 0207 3518126. E-mail: s.kharitonov@imperial.ac.uk
Keywords: asthma, exhaled nitric oxide, fractional exhaled nitric oxide measurements
Received: July 24, 2002
Accepted November 12, 2002
This study was supported by Aerocrine AB, Stockholm, Sweden.
Airway inflammation in asthma is not measured routinely in clinical practice. Fractional exhaled nitric oxide (FENO), a marker of airway inflammation, is increasingly used as an outcome measure in asthma intervention studies and yet the reproducibility of FENO measurements is unknown.
The reproducibility, daytoday, diurnal variation and perception of standardised FENO measurements were examined in 59 subjects (40 children aged 7–13 yrs and 19 adults aged 18–60 yrs), both healthy (n=30) and with mild (n=29) asthma. FENO was measured on five consecutive days (four measurements on the same day) for adults and twice on the same day for children.
The coefficient of reproducibility expressed as the mean pooled standard deviation (n=59, 675 estimations) was 2.11 parts per billion (ppb) and intraclass correlation coefficient was 0.99 in both children and adults. FENO was significantly higher in asthma subjects (32.3 ppb) than in healthy subjects (16.3 ppb). There was no diurnal or daytoday variation, or a learning effect, as the result of FENO measurements were identical at results of the beginning and at the end of the study.
It was concluded that fractional exhaled nitric oxide measurements are simple, reproducible, free from diurnal and daytoday variation, and acceptable by both healthy and asthmatic adults and children, as a part of their routine visit to a physician.
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