2011美国胸科学会官方实践指南：对呼气一氧化氮水平(FeNO)临床意义的解读

中文标题：

2011美国胸科学会官方实践指南：对呼气一氧化氮水平(FeNO)临床意义的解读

英文标题：

An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications

发布机构：

美国胸科学会

发布日期：

2011-05-01

简要介绍：

Background: Measurement of fractional nitric oxide (NO) concentrationin exhaled breath (FENO) is a quantitative, noninvasive, simple,and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease,including asthma. While FENO measurement has been standardized,there is currently no reference guideline for practicing health careproviders to guide them in the appropriate use and interpretation of FENO in clinical practice.Purpose: To develop evidence-based guidelines for the interpretation of FENO measurements that incorporate evidence that has accumulated over the past decade.Methods:We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions,synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach.Results: The evidence related to the use of FENO measurements is reviewed and clinical practice recommendations are provided.Conclusions: In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV1 reversibility or provocation tests are only indirectly associated with airway inflammation.FENO offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2)determining the likelihood of corticosteroid responsiveness, (3)monitoring of airway inflammation to determine the potential need for corticosteroid,and(4) unmaskingof otherwise unsuspectednonadherence to corticosteroid therapy.