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Proof of Concept: Very Rapid Tidal Breathing Nasal Nitric Oxide Sampling Discriminates Primary Ciliary Dyskinesia from Healthy Subjects
Introduction Nasal nitric oxide (nNO) is extremely low in individuals with primary ciliary dyskinesia (PCD) and is recommended as part of early workup. We investigated whether tidal breathing sampling for a few seconds was as discriminative between PCD and healthy controls (HC) as conventional tidal...
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| Published in: | Lung 2019-04, Vol.197 (2), p.209-216 |
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| container_title | Lung |
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| creator | Holgersen, Mathias G. Marthin, June K. Nielsen, Kim G. |
| description | Introduction
Nasal nitric oxide (nNO) is extremely low in individuals with primary ciliary dyskinesia (PCD) and is recommended as part of early workup. We investigated whether tidal breathing sampling for a few seconds was as discriminative between PCD and healthy controls (HC) as conventional tidal breathing sampling (cTB-nNO) for 20–30 s.
Methods
We performed very rapid sampling of tidal breathing (vrTB-nNO) for 2, 4 and 6 s, respectively. Vacuum sampling with applied negative pressure (vrTB-nNO
vac
; negative pressure was applied by pinching the sampling tube) for |
| doi_str_mv | 10.1007/s00408-019-00202-x |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2216772219</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A583840077</galeid><sourcerecordid>A583840077</sourcerecordid><originalsourceid>FETCH-LOGICAL-c511t-dd814b20713137540f159f701651389cb8e738aaef016f092fbed0a6ed7d44f63</originalsourceid><addsrcrecordid>eNp9kttu1DAQhi0EokvhBbhAlpAQNylj5-CEu7IFilS1FS3cWt5kvOslsVM7kXafgNfG2xRK0QrZ8mH8zWg88xPyksERAxDvAkAGZQKsSgA48GTziMxYlvKEiRwekxmkGUt4hA7IsxDWAEwULH9KDlIQBYeKz8jPS--cpnHOna2xH97T7-i39KvqTUOvTaNa-sGjGlbGLum5CvF-bgZvanqxMQ3SK9X17e7txITam85YNWCgl_GoYpy5ac1uP9mGH8ZiMIpq7zp6iqodVlt6NS7WWA_hOXmiVRvwxd1-SL59-ng9P03OLj5_mR-fJXXO2JA0TcmyBQfBUpaKPAPN8koLYEXO0rKqFyWKtFQKdTTp-EO9wAZUgY1oskwX6SF5O8XtvbsZMQyyi3lj2yqLbgySc1YIEdcqoq__Qddu9DZmJzkrgcdMiuKeWqoWpbHaDV7Vu6DyOC_TMoudEpFK9lBLtOhV6yxqE80P-KM9fBwNdqbe6_DmL4fVbXWDa8fBOBsegnwCa-9C8KhlP7VKMpA7WclJVjLKSt7KSm6i06u7UoyLDps_Lr91FIF0AkJ8skv097X6T9hfqi3VkQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2180281466</pqid></control><display><type>article</type><title>Proof of Concept: Very Rapid Tidal Breathing Nasal Nitric Oxide Sampling Discriminates Primary Ciliary Dyskinesia from Healthy Subjects</title><source>Springer Link</source><creator>Holgersen, Mathias G. ; Marthin, June K. ; Nielsen, Kim G.</creator><creatorcontrib>Holgersen, Mathias G. ; Marthin, June K. ; Nielsen, Kim G.</creatorcontrib><description>Introduction
Nasal nitric oxide (nNO) is extremely low in individuals with primary ciliary dyskinesia (PCD) and is recommended as part of early workup. We investigated whether tidal breathing sampling for a few seconds was as discriminative between PCD and healthy controls (HC) as conventional tidal breathing sampling (cTB-nNO) for 20–30 s.
Methods
We performed very rapid sampling of tidal breathing (vrTB-nNO) for 2, 4 and 6 s, respectively. Vacuum sampling with applied negative pressure (vrTB-nNO
vac
; negative pressure was applied by pinching the sampling tube) for < 2 s resulted in enhanced suction of nasal air during measurement. Feasibility, success rate, discriminatory capacity, repeatability and agreement were assessed for all four sampling modalities.
Results
We included 13 patients with PCD, median (IQR) age of 21.8 (12.2–27.7) years and 17 HC, 25.3 (14.5–33.4) years. Measurements were highly feasible (96.7% success rate). Measured NO values with vrTB-nNO modalities differed significantly from TB-nNO measurements (HC:
p
< 0.001, PCD:
p
< 0.05). All modalities showed excellent discrimination. The vacuum method gave remarkably high values of nNO in both groups (1865 vs. 86 ppb), but retained excellent discrimination. vrTB-nNO
4sec
, vrTB-nNO
6sec
and vrTB-nNO
vac
showed identical specificity to cTB-nNO (all: 1.0, 95% CI 0.77–1.0).
Conclusion
vrTB-nNO sampling requires only a few seconds of probe-in-nose time, is feasible, and provides excellent discrimination between PCD and HC. Rapid TB-nNO sampling needs standardisation and further investigations in infants, young children and patients referred for PCD workup.</description><identifier>ISSN: 0341-2040</identifier><identifier>EISSN: 1432-1750</identifier><identifier>DOI: 10.1007/s00408-019-00202-x</identifier><identifier>PMID: 30762092</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Adult ; Aged ; Airway Biology ; Biomarkers - metabolism ; Breath Tests ; Breathing ; Case-Control Studies ; Child ; Children ; Ciliary Motility Disorders - diagnosis ; Ciliary Motility Disorders - metabolism ; Ciliary Motility Disorders - physiopathology ; Diagnosis ; Feasibility Studies ; Female ; Humans ; Infants ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Movement disorders ; Nitric oxide ; Nitric Oxide - metabolism ; Nose ; Patients ; Pneumology/Respiratory System ; Predictive Value of Tests ; Pressure ; Primary ciliary dyskinesia ; Proof of Concept Study ; Reproducibility of Results ; Respiration ; Risk factors ; Sampling ; Suction ; Time Factors ; Vacuum ; Young Adult</subject><ispartof>Lung, 2019-04, Vol.197 (2), p.209-216</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>COPYRIGHT 2019 Springer</rights><rights>Lung is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-dd814b20713137540f159f701651389cb8e738aaef016f092fbed0a6ed7d44f63</citedby><cites>FETCH-LOGICAL-c511t-dd814b20713137540f159f701651389cb8e738aaef016f092fbed0a6ed7d44f63</cites><orcidid>0000-0001-9944-6253 ; 0000-0002-4420-3091 ; 0000-0001-5906-9449</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30762092$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Holgersen, Mathias G.</creatorcontrib><creatorcontrib>Marthin, June K.</creatorcontrib><creatorcontrib>Nielsen, Kim G.</creatorcontrib><title>Proof of Concept: Very Rapid Tidal Breathing Nasal Nitric Oxide Sampling Discriminates Primary Ciliary Dyskinesia from Healthy Subjects</title><title>Lung</title><addtitle>Lung</addtitle><addtitle>Lung</addtitle><description>Introduction
Nasal nitric oxide (nNO) is extremely low in individuals with primary ciliary dyskinesia (PCD) and is recommended as part of early workup. We investigated whether tidal breathing sampling for a few seconds was as discriminative between PCD and healthy controls (HC) as conventional tidal breathing sampling (cTB-nNO) for 20–30 s.
Methods
We performed very rapid sampling of tidal breathing (vrTB-nNO) for 2, 4 and 6 s, respectively. Vacuum sampling with applied negative pressure (vrTB-nNO
vac
; negative pressure was applied by pinching the sampling tube) for < 2 s resulted in enhanced suction of nasal air during measurement. Feasibility, success rate, discriminatory capacity, repeatability and agreement were assessed for all four sampling modalities.
Results
We included 13 patients with PCD, median (IQR) age of 21.8 (12.2–27.7) years and 17 HC, 25.3 (14.5–33.4) years. Measurements were highly feasible (96.7% success rate). Measured NO values with vrTB-nNO modalities differed significantly from TB-nNO measurements (HC:
p
< 0.001, PCD:
p
< 0.05). All modalities showed excellent discrimination. The vacuum method gave remarkably high values of nNO in both groups (1865 vs. 86 ppb), but retained excellent discrimination. vrTB-nNO
4sec
, vrTB-nNO
6sec
and vrTB-nNO
vac
showed identical specificity to cTB-nNO (all: 1.0, 95% CI 0.77–1.0).
Conclusion
vrTB-nNO sampling requires only a few seconds of probe-in-nose time, is feasible, and provides excellent discrimination between PCD and HC. Rapid TB-nNO sampling needs standardisation and further investigations in infants, young children and patients referred for PCD workup.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Airway Biology</subject><subject>Biomarkers - metabolism</subject><subject>Breath Tests</subject><subject>Breathing</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Children</subject><subject>Ciliary Motility Disorders - diagnosis</subject><subject>Ciliary Motility Disorders - metabolism</subject><subject>Ciliary Motility Disorders - physiopathology</subject><subject>Diagnosis</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Infants</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Movement disorders</subject><subject>Nitric oxide</subject><subject>Nitric Oxide - metabolism</subject><subject>Nose</subject><subject>Patients</subject><subject>Pneumology/Respiratory System</subject><subject>Predictive Value of Tests</subject><subject>Pressure</subject><subject>Primary ciliary dyskinesia</subject><subject>Proof of Concept Study</subject><subject>Reproducibility of Results</subject><subject>Respiration</subject><subject>Risk factors</subject><subject>Sampling</subject><subject>Suction</subject><subject>Time Factors</subject><subject>Vacuum</subject><subject>Young Adult</subject><issn>0341-2040</issn><issn>1432-1750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kttu1DAQhi0EokvhBbhAlpAQNylj5-CEu7IFilS1FS3cWt5kvOslsVM7kXafgNfG2xRK0QrZ8mH8zWg88xPyksERAxDvAkAGZQKsSgA48GTziMxYlvKEiRwekxmkGUt4hA7IsxDWAEwULH9KDlIQBYeKz8jPS--cpnHOna2xH97T7-i39KvqTUOvTaNa-sGjGlbGLum5CvF-bgZvanqxMQ3SK9X17e7txITam85YNWCgl_GoYpy5ac1uP9mGH8ZiMIpq7zp6iqodVlt6NS7WWA_hOXmiVRvwxd1-SL59-ng9P03OLj5_mR-fJXXO2JA0TcmyBQfBUpaKPAPN8koLYEXO0rKqFyWKtFQKdTTp-EO9wAZUgY1oskwX6SF5O8XtvbsZMQyyi3lj2yqLbgySc1YIEdcqoq__Qddu9DZmJzkrgcdMiuKeWqoWpbHaDV7Vu6DyOC_TMoudEpFK9lBLtOhV6yxqE80P-KM9fBwNdqbe6_DmL4fVbXWDa8fBOBsegnwCa-9C8KhlP7VKMpA7WclJVjLKSt7KSm6i06u7UoyLDps_Lr91FIF0AkJ8skv097X6T9hfqi3VkQ</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Holgersen, Mathias G.</creator><creator>Marthin, June K.</creator><creator>Nielsen, Kim G.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9944-6253</orcidid><orcidid>https://orcid.org/0000-0002-4420-3091</orcidid><orcidid>https://orcid.org/0000-0001-5906-9449</orcidid></search><sort><creationdate>20190401</creationdate><title>Proof of Concept: Very Rapid Tidal Breathing Nasal Nitric Oxide Sampling Discriminates Primary Ciliary Dyskinesia from Healthy Subjects</title><author>Holgersen, Mathias G. ; Marthin, June K. ; Nielsen, Kim G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-dd814b20713137540f159f701651389cb8e738aaef016f092fbed0a6ed7d44f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Airway Biology</topic><topic>Biomarkers - metabolism</topic><topic>Breath Tests</topic><topic>Breathing</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Children</topic><topic>Ciliary Motility Disorders - diagnosis</topic><topic>Ciliary Motility Disorders - metabolism</topic><topic>Ciliary Motility Disorders - physiopathology</topic><topic>Diagnosis</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Infants</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Movement disorders</topic><topic>Nitric oxide</topic><topic>Nitric Oxide - metabolism</topic><topic>Nose</topic><topic>Patients</topic><topic>Pneumology/Respiratory System</topic><topic>Predictive Value of Tests</topic><topic>Pressure</topic><topic>Primary ciliary dyskinesia</topic><topic>Proof of Concept Study</topic><topic>Reproducibility of Results</topic><topic>Respiration</topic><topic>Risk factors</topic><topic>Sampling</topic><topic>Suction</topic><topic>Time Factors</topic><topic>Vacuum</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Holgersen, Mathias G.</creatorcontrib><creatorcontrib>Marthin, June K.</creatorcontrib><creatorcontrib>Nielsen, Kim G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Lung</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Holgersen, Mathias G.</au><au>Marthin, June K.</au><au>Nielsen, Kim G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proof of Concept: Very Rapid Tidal Breathing Nasal Nitric Oxide Sampling Discriminates Primary Ciliary Dyskinesia from Healthy Subjects</atitle><jtitle>Lung</jtitle><stitle>Lung</stitle><addtitle>Lung</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>197</volume><issue>2</issue><spage>209</spage><epage>216</epage><pages>209-216</pages><issn>0341-2040</issn><eissn>1432-1750</eissn><abstract>Introduction
Nasal nitric oxide (nNO) is extremely low in individuals with primary ciliary dyskinesia (PCD) and is recommended as part of early workup. We investigated whether tidal breathing sampling for a few seconds was as discriminative between PCD and healthy controls (HC) as conventional tidal breathing sampling (cTB-nNO) for 20–30 s.
Methods
We performed very rapid sampling of tidal breathing (vrTB-nNO) for 2, 4 and 6 s, respectively. Vacuum sampling with applied negative pressure (vrTB-nNO
vac
; negative pressure was applied by pinching the sampling tube) for < 2 s resulted in enhanced suction of nasal air during measurement. Feasibility, success rate, discriminatory capacity, repeatability and agreement were assessed for all four sampling modalities.
Results
We included 13 patients with PCD, median (IQR) age of 21.8 (12.2–27.7) years and 17 HC, 25.3 (14.5–33.4) years. Measurements were highly feasible (96.7% success rate). Measured NO values with vrTB-nNO modalities differed significantly from TB-nNO measurements (HC:
p
< 0.001, PCD:
p
< 0.05). All modalities showed excellent discrimination. The vacuum method gave remarkably high values of nNO in both groups (1865 vs. 86 ppb), but retained excellent discrimination. vrTB-nNO
4sec
, vrTB-nNO
6sec
and vrTB-nNO
vac
showed identical specificity to cTB-nNO (all: 1.0, 95% CI 0.77–1.0).
Conclusion
vrTB-nNO sampling requires only a few seconds of probe-in-nose time, is feasible, and provides excellent discrimination between PCD and HC. Rapid TB-nNO sampling needs standardisation and further investigations in infants, young children and patients referred for PCD workup.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30762092</pmid><doi>10.1007/s00408-019-00202-x</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9944-6253</orcidid><orcidid>https://orcid.org/0000-0002-4420-3091</orcidid><orcidid>https://orcid.org/0000-0001-5906-9449</orcidid></addata></record> |
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| subjects | Adolescent Adult Aged Airway Biology Biomarkers - metabolism Breath Tests Breathing Case-Control Studies Child Children Ciliary Motility Disorders - diagnosis Ciliary Motility Disorders - metabolism Ciliary Motility Disorders - physiopathology Diagnosis Feasibility Studies Female Humans Infants Male Medicine Medicine & Public Health Middle Aged Movement disorders Nitric oxide Nitric Oxide - metabolism Nose Patients Pneumology/Respiratory System Predictive Value of Tests Pressure Primary ciliary dyskinesia Proof of Concept Study Reproducibility of Results Respiration Risk factors Sampling Suction Time Factors Vacuum Young Adult |
| title | Proof of Concept: Very Rapid Tidal Breathing Nasal Nitric Oxide Sampling Discriminates Primary Ciliary Dyskinesia from Healthy Subjects |
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