CLINICAL SIGNIFICANCE OF EXPIRED AIR NITRIC OXIDE FRACTIONAL DETERMINATION AS INSTRUMENT OF DIAGNOSIS AND THERAPEUTIC EFFICIENCY ASSESSMENT OF PEDIATRIC CHRONIC RESPIRATORY DISEASES

Aim. To analyze new possibilities of fractional determination of the expired air nitric oxide. Materials and methods. 120 children aged 2-18, ill with bronchial asthma, primary ciliary dyskinesia (PCD) and other diseases were examined. To carry out fractional determination of the expired air nitric oxide, Analyzer CLD88 (ECO MEDICS®, Switzerland) was used. Estimation of the results of alveolar test (subsequent thrice-repeated determination of Fe NO with the expiratory rate of 30, 100 and 300 l/min) was performed by the following parameters: Ca NO (alveolar NO concentration); Caw NO (NO concentration in the upper airway tissues); Daw NO (NO duffusion rate); Jaw NO (NO flow from the upper airway tissues); Fe NO50 (extrapolated Fe NO value with the expiratory rate of 50 ml/s). Results. Caw NO level moderately correlated (r=0,58) with the nasal nitric oxide level and ranged from 5,7 ppb (in PCD patients) to 473,5 ppb (in a child with severe BA associated with exacerbated allergic rhinitis). Higher correlation degree was revealed between Jaw NO level (166,6÷8815,8 pl/s) and Fe NO and Fe NO50 level ( r =0,82 and r =0,78, respectively). Conclusion. Differentially diagnostic significance of the determined indices in bronchial asthma and primary ciliary dyskinesia was shown.

Children, expired air nitric oxide fractional determination, bronchial asthma, primary ciliary dyskinesia, functional diagnosis