A Karger 'Publishing Highlights 1890–2015' title This book represents a comprehensive review of the most recent developments in paediatric pulmonary function testing and their clinical applications in common paediatric respiratory disorders.
The first section reviews the current lung function tests used in infants and toddlers who are by nature unable to cooperate with most testing procedures. It describes the methodologies, provides normal values where available, and gives advice for data interpretation. The second section deals with the classic adult-type pulmonary function tests and their application in the semi-cooperative or cooperative older child. Age-related technical issues and the limitations of these tests are considered. Tests assessing the respiratory system beyond the usual measurements of mechanics, lung volume, and bronchial responsiveness are covered in the third section. These include the measurements of respiratory muscle function, work of breathing, diffusing capacity, and inflammatory markers in exhaled air and breath condensate. The fourth section discusses the clinical usefulness of pulmonary function tests in the diagnosis and management of the most common paediatric respiratory disorders including asthma, cystic fibrosis and neuromuscular disorders, as well as in the follow-up care after lung or bone marrow transplantation or after neonatal lung disease. This part is unique, since no books previously published in the field of paediatric lung function testing have considered its clinical value in the individual patient. Finally, the future role of pulmonary function testing in the neonatal and paediatric intensive care unit is evaluated.
Practical and up-to-date, this textbook is of special interest for paediatric and adult pulmonologists, paediatric intensivists, general paediatricians and physicians in training for these specialties, as well as for pulmonary function technicians and respiratory therapists.
181 - 189: Measurement of Nasal Nitric Oxide
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Published:2005
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Book Series: Progress in Respiratory Research
Regula Corbelli, Jürg Hammer, 2005. "Measurement of Nasal Nitric Oxide", Paediatric Pulmonary Function Testing, J. Hammer, E. Eber
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Abstract
The major part of nitric oxide (NO) in exhaled air originatesfrom the nasal airways, with only minor contributionfrom the lower airways and the oral cavity. The physiologicalrole of the very high local NO concentration in theparanasal sinuses is still unclear. The most widely used andbest-standardized method to sample nasal NO in isolationfrom the lower respiratory tract is aspiration at a fixedflow through the nasal passages in series. Important technicalconsiderations include the choice of the correcttransnasal flow and the ability of children to perform abreath-holding manoeuvre.The effects of age and height onnasal NO values have yet to be defined in a larger populationof healthy children using the recommended aspirationtechnique. Presently, there is no validated technique availableto measure nasal NO in infants and small children.Themeasurement of nasal NO concentrations has evokedinterest in its potential to serve as a non-invasive andsimple diagnostic tool for upper and lower respiratory tractdisorders. Measurements of nasal NO concentrations arehelpful to screen children with clinical symptoms suggestiveof primary ciliary dyskinesia and to exclude this diseasein those with high nasal NO concentrations with highcertainty. Nasal NO measurements are, however, of nodiagnostic utility in distinguishing between other conditionssuch as asthma, cystic fibrosis, bronchiectasis, sinusitis orrhinitis, or in monitoring therapeutic interventions in anysuch disorder.
