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23 May 2019 : Clinical Research  

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

Haiyan Zhu1BCDEF, Rongrong Zhang1ABCDEFG*, Chuangli Hao2BCDF, Xingmei Yu2BCD, Zhaofang Tian1BCF, Yufang Yuan1BF

DOI: 10.12659/MSM.913761

Med Sci Monit 2019; 25:3832-3838


BACKGROUND: Cough variant asthma in children presents with a dry nonproductive cough. This study aimed to investigate the diagnostic value of fractional exhaled nitric oxide (FeNO) combined with small airway functional parameters in cough variant asthma.

MATERIAL AND METHODS: Children with asthma (n=136) were divided into a cough variant asthma (CVA) group (n=57; mean age, 8.03±2.1 years) and a non-cough variant asthma (nCVA) group (n=79; mean age, 8.61±1.7 years). In both groups, FeNO and other pulmonary function parameters were measured including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF), forced expiratory flow (FEF), and maximum expiratory flow at 25%, 50%, and 75% expired volume (MEF25, MEF50, and MEF75). Receiver-operating characteristic (ROC) curve analysis compared the sensitivity and specificity between the diagnostic parameters.

RESULTS: The FeNO values were significantly increased in the CVA group compared with the nCVA group (Z=6.890, p<0.001). The MMEF, MEF25, MEF50, and MEF75 values were significantly lower in the CVA group compared with the nCVA group (p=0.000, p=0.014, p=0.000, and p=0.000, respectively). The FeNO values were negatively correlated with MEF25, MEF50, and MMEF (ρ=–0.334, ρ=–0.257 and ρ=–0.276, respectively). FeNO was significantly more efficient diagnosing cough variant asthma comparing with pulmonary parameters (p<0.05), and was most sensitive and specific when combined with MMEF/MEF50 compared with single diagnostic parameters (p<0.05).

CONCLUSIONS: FeNO combined with pulmonary function parameters of MMEF/MEF50 showed increased sensitivity and specificity for the diagnosis of cough variant asthma.

Keywords: airway remodeling, Asthma, Cough, Respiratory Function Tests, Breath Tests, Child, Child, Preschool, Exhalation, Forced Expiratory Volume, Lung, Nitric Oxide, Pulmonary Elimination, ROC Curve, Sensitivity and Specificity, Vital Capacity

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Editorial: Infectious Disease Surveillance Using Artificial Intelligence (AI) and its Role in Epidemic and Pandemic Preparedness

Dinah V. Parums
Science Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA

DOI: 10.12659/MSM.941209

Med Sci Monit 2023; 29:e941209


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750