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Published online before print February 14, 2007
Eur Respir J 2007, doi:10.1183/09031936.00149706
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ORIGINAL ARTICLE

Use of different exhaled nitric oxide multiple flow rate models in COPD

K. Roy 1*, Z.L. Borrill 1, C. Starkey 1, A.L. Hazel 2, J. Morris 3, J. Vestbo 4, D. Singh 1

1 Medicines Evaluation Unit, North West Lung Centre, University Of Manchester, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9QZ
2 Dept of Mathematics, University of Manchester, Oxford Road, Manchester, M13 9PL, U.K
3 Medical Statistics, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT
4 Medicines Evaluation Unit, North West Lung Centre, University Of Manchester, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9QZ; and Dept of Cardiology and Respiratory Medicine, Hvidovre Hospital, 2650 Hvidovre, Denmark

* To whom correspondence should be addressed. E-mail: kroy{at}meu.org.uk.


  Abstract

Multiple flow rates FeNO data can be modelled to estimate NO airway wall concentration (CawNO) and diffusing capacity (DawNO), alveolar concentration (CalvNO) and maximal flux (J'awNO). FeNO at 10, 30, 50, 100 and 200ml·s-1 from 50 COPD patients and 35 healthy controls (smokers and non-smokers) modelled by five different methods was compared and the effect of the number of flow rates was investigated. All methods showed that current smoking reduced CawNO in COPD patients, with some methods showing that smoking reduced J'awNO. Smoking did not affect CalvNO and DawNO. For CawNO, the methods gave similar results, but there was variability between methods for J'awNO, CalvNO and DawNO. The median error by least squares fitting between modelled and actual data was significantly lower for the non linear (1.96) compared to mixed methods (3.31 and 3.62). Parameters calculated by the non-linear method using five and four flow rates were significantly different; ratio (95% CI) of CawNO was 2.02 (1.45, 2.83). NO models give different results, although CawNO is relatively model independent. Non-linear modelling has the least error, suggesting it is the best method. The number of flow rates should be standardised

Keywords:  Chronic obstructive pulmonary disease, nitric oxide, two compartment modelling




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J. S. Sundy, D. W. Hauswirth, S. Mervin-Blake, C. A. Fernandez, K. B. Patch, K. M. Alexander, S. Allgood, P. D. McNair, and M. C. Levesque
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Eur. Respir. J., December 1, 2007; 30(6): 1074 - 1081.
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