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Jason S. Debley, MD, MPH, David C. Stamey, RRT, Elizabeth S

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Presentation on theme: "Jason S. Debley, MD, MPH, David C. Stamey, RRT, Elizabeth S"— Presentation transcript:

1 Exhaled nitric oxide, lung function, and exacerbations in wheezy infants and toddlers 
Jason S. Debley, MD, MPH, David C. Stamey, RRT, Elizabeth S. Cochrane, BS, Kim L. Gama, BA, Gregory J. Redding, MD  Journal of Allergy and Clinical Immunology  Volume 125, Issue 6, Pages e13 (June 2010) DOI: /j.jaci Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

2 Fig 1 Relationship between SB-eNO levels and bronchodilator responsiveness (BR). BR is defined as a 12% or greater improvement in FEV0.5 or a 25% or greater improvement in FEF25-75 after administration of albuterol (open triangles). Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

3 Fig 2 Enrollment SB-eNO levels in subjects treated with systemic (oral or intravenous) steroids for an acute episode of wheezing during the follow-up period (open triangles) versus SB-eNO levels in subjects not treated with systemic steroids (solid circles). Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

4 Superimposed SB-eNO and expiratory flow tracings from a single-breath expiratory maneuver. The blue tracing illustrates an acceptable SB-eNO plateau, and the green tracing illustrates an acceptable expiratory flow plateau. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

5 Flowchart of the patients in the study
Flowchart of the patients in the study. Of the 8 subjects who did not complete infant pulmonary function testing (PFT) at visit 2, 4 could not be adequately sedated, and PFT results from 4 subjects did not meet American Thoracic Society/European Respiratory Society guidelinesE2 for acceptable infant spirometry because of glottic closures. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

6 Plot of number of subjects enrolled by time of year in 3-month intervals based on seasons.
Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

7 Enrollment SB-eNO levels in subjects based on subsequent change in FEV0.5(A), FEF25-75(B), and FEF75(C)z scores. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

8 Correlation between enrollment SB-eNO level and change in FEV0
Correlation between enrollment SB-eNO level and change in FEV0.5(A), FEF25-75(B), and FEF75(C)z scores during the 6-month follow-up period. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

9 Area under the ROC curve (AUC) for enrollment SB-eNO level as a predictor for a decrease in FEV0.5 during the study follow-up period. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

10 Area under the ROC curves (AUC) obtained for enrollment SB-eNO level (A), enrollment FEV0.5(B), and enrollment FEF25-75(C) as predictors of wheezing exacerbations treated with systemic corticosteroids during follow-up. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

11 Correlation between SB-eNO levels at enrollment (visit 1) and the 6-month follow-up visits (visit 2), excluding subjects who used inhaled corticosteroids. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

12 Change in SB-eNO levels between enrollment and follow-up visits in subjects who did not use inhaled corticosteroids (A) and those who did use inhaled corticosteroids (B) during the follow-up period. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

13 Correlation between change in SB-eNO levels and change in FEV0
Correlation between change in SB-eNO levels and change in FEV0.5(A), FEF25-75(B), and FEF75(C)z scores during the 6-month follow-up period. Subjects using inhaled corticosteroids during the follow-up period were excluded from analysis. Journal of Allergy and Clinical Immunology  , e13DOI: ( /j.jaci ) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

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