Rg. Canady et al., Vital capacity reservoir and online measurement of childhood nitrosopnea are linearly related clinical implications, AM J R CRIT, 159(1), 1999, pp. 311-314
Hypernitrosopnea, a robust marker for childhood asthma, is measured reprodu
cibly in mixed vital capacity (VC) expirates. Recent guidelines for measure
ment of expired nitric oxide (NO) in adults have favored use of an online (
OL), flow-dependent technique. We compared VC and OL NO measurements in 14
asthmatic and 11 control children 5 through 18 yr of age. After spirometry,
subjects breathed both into an open-ended reservoir (20 cm H2O resistance)
and into a tedlar bag (VC maneuver). End-expiratory pressure > 5 cm H2O wa
s continuously maintained during VC measurements, and the velum remained sh
ut. Eight additional children (24% of total number of subjects) were unable
reproducibly to perform the OL measurement at constant flow (six asthmatic
s; two control children). For subjects able to perform the OL technique, OL
and VC NO measurements were linearly related (r(2) = 0.88). In children, V
C NO assays are reproducible, sensitive in identifying asthma, and portable
. Additionally, we have shown that (1) not all children are able to perform
OL measurements, and (2) VC measurements vary linearly with OL measurement
s. These findings suggest that there may not be compelling reason to favor
OL over VC measurements for hypernitrosopnea in children with asthma.