Nasal nitric oxide in cystic fibrosis with and without humming.
ABSTRACT Nasal nitric oxide (nNO) values are reduced in patients with cystic fibrosis (CF). Humming during nNO measurement increases nNO values in healthy subjects. Nasal NO is reduced in patients with CF, sinus disease or nasal polyps. Humming nNO values have not been reported in CF patients yet. Our aim was to explore humming nNO values in CF patients and assess whether nNO during humming is a better discriminator than silent nNO measurements in this patient group.
In a cross sectional study we measured nNO concentrations in healthy controls (HC) and in CF patients (n = 23 and 31, respectively). The participants held their breath for 10 s while air was passively extracted from one nostril with 700 mL min(-1) for direct NO measurements (NIOX chemiluminescence analyser). Subsequently nNO was measured during humming with the mouth closed for 10 s.
Mean nNO in parts per billion (p.p.b.) (SD) during breath hold was 499 (164) and 240 (139), respectively. The median nNO peak (p.p.b., minimum-maximum) during humming was 1500 (425-4100) for HC and 120 (23-500) for CF. There was a highly significant difference between nNO both with and without humming between CF and HC (P < 0.01). The sensitivity and specificity of nNO for detecting CF were better with humming.
Nasal NO concentrations with and without humming are significantly decreased in CF. Humming nNO is an excellent discriminator between HC and CF and performs better than silent nNO.
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ABSTRACT: Nitric oxide levels may reflect the inflammatory status of both the upper and lower airways. Measurement of exhaled bronchial nitric oxide is a useful, non-invasive tool in the diagnosis and management of eosinophilic asthma. Nasal nitric oxide may be normal, raised or lowered in disease states; however measurement may be a useful tool in the diagnosis and management of patients with chronic rhinosinusitis, nasal polyps, and cystic fibrosis, as well as in the diagnosis of primary ciliary dyskinesia. Further research is aimed at investigating the role of nitric oxide in allergic rhinitis and nasal congestion. Measuring both bronchial and nasal nitric oxide may assist the combined management of upper and lower airways.Rhinology 07/2009; 47(2):115-20. · 1.32 Impact Factor