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Measurement of Exhaled Nitric Oxide of Lung Origin

Conference paper
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Summary

The concentration of nitric oxide ([NO]) in human exhaled air has been repeatedly reported as a promising parameter which reflects inflammatory processes of airway diseases such as bronchial asthma. However, since the exact source of exhaled NO has not been fully understood, we first examined the effects of endotracheal intubation and of breath holding on exhaled [NO] in normal humans. Using a specially-designed gas sampling system, we divided exhaled air into two fractions, the initially exhaled 200ml (Fraction 1; F1) and the remainder (Fraction 2; F2). Before intubation, exhaled [NO] was 15.5 ± 3.6 ppb in F1 and 10.3 ± 2.4 ppb in F2. Compared to these values, [NO] after intubation significantly decreased by 59.2 ± 10.6 (SD)% in Fl and by 54.4±8.0% in F2. Breath holding under endotracheal intubation significantly increased exhaled [NO] only in Fraction 1. In the next study, we developed a nasal continuous negative pressure technique which, we verified, caused closure of the vellum and removed nasal NO contamination, and measured orally exhaled [NO] of healthy humans and of patients with bronchial asthma. In patients with bronchial asthma, exhaled [NO] obtained with nasal continuous negative pressure (CNP) was 20.8 ±3.4 ppb in Fraction 1, and 19.4±4.2 ppb in Fraction 2, both of which wrewere significantly higher than that of healthy humans. These results indicate those about 55–60% of exhaled NO is derived from the upper airways in healthy humans when they breathe wearing a noseclip, and that production of NO in intrathoracic airways is augmented in patients with asthma compared to healthy humans.

Key Words

Human endotracheal intubation bronchial asthma Intrathoracic airways 

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Copyright information

© Springer Japan 1999

Authors and Affiliations

  1. 1.First Department of MedicineHokkaido University School of MedicineSapporo, HokkaidoJapan

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