Assessing the suitability of fractional exhaled nitric oxide (FENO) cut-off ranges for aboriginal and/or Torres Strait Islander children and young adults

Abstract

Introduction/Aim: Fractional exhaled nitric oxide (FeNO) is used as a non-invasive measure of eosinophilic airway inflammation. It is unknown how appropriate the recommended FeNO cut-off ranges are for Aboriginal and/or Torres Strait Islander patients. Our aim was to assess the distribution of healthy Aboriginal and/or Torres Strait Islander FeNO results according to current American Thoracic Society cut-off guidelines. Methods: We measured FeNO (using Aerocrine NioxMINO) in 991 Indigenous children and young adults (aged 3 to 25 years) from seven Queensland communities. Questionnaires and medical charts were reviewed to identify healthy participants (no respiratory and/or atopic illness ever). Results: Acceptable FeNO measurements were achieved by 553 children (≤12 years) and 288 adults (>12 years). Participants with a history of respiratory and/or atopy conditions were excluded resulting in a healthy cohort of children (n=401, 72.5%) and adults (n=193, 67%). The geometric mean FeNO results for children and adults were 11.1ppb and 12.5ppb respectively. Table 1 summarises the distribution of healthy FeNO results for each ethnic group according to current cut-off ranges. Conclusion: Although the majority of participants had FeNO results within the age-respective normal ranges, we found a proportion of healthy participants with elevated FeNO results in all groups. The greatest proportion of elevated results was seen in Torres Strait Islander children and adults, and Aboriginal/Torres Strait Islander children. This suggests that the recommended cut-off ranges may not be appropriate for these groups. Further investigation is still needed. (Table presented).L6220914222018-05-16 <br />