An international survey on nasal nitric oxide measurement practices for the diagnosis of primary ciliary dyskinesia
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Nasal nitric oxide (nNO) measurements are used in the assessment of patients suspected of having primary ciliary dyskinesia (PCD), but recommendations for performing such measurements have not focused on children and do not include all current practices. To guide the development of a European Respiratory Society-supported technical standard for nNO measurement in children, an international online survey was conducted to better understand current measurement practices among providers involved in PCD diagnostics. 78 professionals responded, representing 65 centres across 18 countries, mainly in Europe and North America. Nearly all centres measured nNO in children and more than half performed measurements before 5 years of age. The test was often postponed in children with signs of acute airway infection. In Europe, the electrochemical technique was more frequently used than chemiluminescence. A similar proportion of centres performed measurements during exhalation against a resistance (49 out of 65) or during tidal breathing (50 out of 65); 15 centres used only exhalation against a resistance and 15 used only tidal breathing. The cut-off values used to discriminate PCD were consistent across centres using chemiluminescence analysers; these centres reported results as an output (nL·min−1). Cut-off values were highly variable across centres using electrochemical devices, and nNO concentrations were typically reported as ppb. This survey is the first to determine real-world use of nNO measurements globally and revealed remarkable variability in methodology, equipment and interpretation. These findings will help standardise methods and training.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 00708-2021 |
| Tidsskrift | ERJ Open Research |
| Vol/bind | 8 |
| Udgave nummer | 2 |
| Antal sider | 9 |
| ISSN | 2312-0541 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Conflict of interest: N. Beydon declares no competing interests. T. Ferkol declares no competing interests. A.L. Harris declares no competing interests. M. Colas declares no competing interests. S.D. Davis declares grant NIH U54 HL09640958 funded by the Office of Rare Diseases Research (NCATS) in the 36 months prior to manuscript submission, and membership of the PCD Foundation Medical and Scientific Advisory Council. E. Haarman declares no competing interests. C. Hogg declares no competing interests. E. Kilbride declares no competing interests. P. Kouis declares no competing interests. C.E. Kuehni declares no competing interests. P. Latzin declares grants to their institution from Vertex and Vifor; payment to their institution and themself for lectures, presentations, speaker bureaus, manuscript writing or educational events from Vertex, Vifor and OM Pharma; and paid (to their institution and/or themself) participation on data safety monitoring or advisory boards for Polyphor, Santhera (DMC), Vertex, OM Pharma, Vifor and Sanofi Aventis, all in the 36 months prior to manuscript submission. D. Marangu declares no competing interests. J. Marthin declares no competing interests. K.G. Nielsen declares no competing interests. P. Robinson declares no competing interests. N. Rumman declares no competing interests. M. Rutter declares no competing interests. W. Walker declares no competing interests. J.S. Lucas declares no competing interests.
Funding Information:
The authors are all members of the European Respiratory Society Task Force ?Nasal nitric oxide measurement in children for the diagnosis of primary ciliary dyskinesis: a technical standard? (ERS TF-2020-02).
Publisher Copyright:
© The authors 2022.
ID: 313773449