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Korean J Pediatr 2012 September;55(9) :330-336.
Published online 2012 September 14.        doi:
Fractional exhaled nitric oxide and forced expiratory flow between 25% and 75% of vital capacity in children with controlled asthma
Ji-Yong Yoon (Yoon JY)1, Sung-Il Woo (Woo SI)1, Heon Kim (Kim HE)2, Yong-Han Sun (Sun YH)3, Youn-Soo Hahn (Hahn YS)1
1Departments of Pediatrics, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
2Departments of Preventive Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea
3Department of Pediatrics, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea
Corresponding Author: Youn-Soo Hahn ,Tel: +82-43-269-6042, Fax: +82-43-264-6620, Email:
Copyright © 2012 by The Korean Pediatric Society
Purpose: Fractional exhaled nitric oxide (FeNO) and forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) are not included in routine monitoring of asthma control. We observed changes in FeNO level and FEF25-75 after FeNO-based treatment with inhaled corticosteroid (ICS) in children with controlled asthma (CA). Methods: We recruited 148 children with asthma (age, 8 to 16 years) who had maintained asthma control and normal forced expiratory volume in the first second (FEV1) without control medication for 3 months. Patients with FeNO levels >25 ppb were allocated to the ICStreated (FeNO-based management) or untreated group (guideline-based management). Changes in spirometric values and FeNO levels from baseline were evaluated after 6 weeks. Results: Ninety-three patients had FeNO levels >25 ppb. These patients had lower FEF25-75 % predicted values than those with FeNO levels 25 ppb (P<0.01). After 6 weeks, the geometric mean (GM) FeNO level in the ICS-treated group was 45% lower than the baseline value, and the mean percent increase in FEF25-75 was 18.7% which was greater than that in other spirometric values. There was a negative correlation between percent changes in FEF25-75 and FeNO (r=-0.368, P=0.001). In contrast, the GM FeNO and spirometric values were not significantly different from the baseline values in the untreated group. Conclusion: The anti-inflammatory treatment simultaneously improved the FeNO levels and FEF25-75 in CA patients when their FeNO levels were >25 ppb.
Keywords: Nitric oxide | Spirometry | Inhaled corticosteroids | Asthma | Child
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Supplementary Material  Supplementary Material
Utility of a forced expiratory flow of 25 to 75 percent as a predictor in children with asthma  2008 March;51(3)
Relationship between exhaled nitric oxide and pulmonary function test in children with asthma  2008 February;51(2)
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