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Open Access Research article

Validation of a portable nitric oxide analyzer for screening in primary ciliary dyskinesias

Amanda Harris12, Esther Bhullar1, Kerry Gove2, Rhiannon Joslin1, Jennifer Pelling1, Hazel J Evans12, Woolf T Walker123 and Jane S Lucas123*

Author Affiliations

1 Primary Ciliary Dyskinesia Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK

2 NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

3 Clinical and Experimental Sciences Academic Unit (Mail Point 803), University of Southampton Faculty of Medicine, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK

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BMC Pulmonary Medicine 2014, 14:18  doi:10.1186/1471-2466-14-18

Published: 10 February 2014

Abstract

Background

Nasal nitric oxide (nNO) levels are very low in primary ciliary dyskinesia (PCD) and it is used as a screening test.

Methods

We assessed the reliability and usability of a hand-held analyser in comparison to a stationary nitric oxide (NO) analyser in 50 participants (15 healthy, 13 PCD, 22 other respiratory diseases; age 6–79 years). Nasal NO was measured using a stationary NO analyser during a breath-holding maneuver, and using a hand-held analyser during tidal breathing, sampling at 2 ml/sec or 5 ml/sec. The three methods were compared for their specificity and sensitivity as a screen for PCD, their success rate in different age groups, within subject repeatability and acceptability. Correlation between methods was assessed.

Results

Valid nNO measurements were obtained in 94% of participants using the stationary analyser, 96% using the hand-held analyser at 5 ml/sec and 76% at 2 ml/sec. The hand-held device at 5 ml/sec had excellent sensitivity and specificity as a screening test for PCD during tidal breathing (cut-off of 30 nL/min,100% sensitivity, >95% specificity). The cut-off using the stationary analyser during breath-hold was 38 nL/min (100% sensitivity, 95% specificity). The stationary and hand-held analyser (5 ml/sec) showed reasonable within-subject repeatability(% coefficient of variation = 15).

Conclusion

The hand-held NO analyser provides a promising screening tool for PCD.

Keywords:
Nasal nitric oxide; Primary ciliary dyskinesia; Nitric oxide analyser