Background: Fractional exhaled Nitric Oxide (FeNO) has been used to diagnose and monitor asthma. It is a non-invasive marker of airway inflammation. Infections of the airways have been established to complicate post-operative complications. Children with upper respiratory tract infections had a significantly higher incidence of pulmonary complications. We hypothesize that FeNO levels predict post-operative airway reactivity among children with congenital cardiac anomaly.
Patients and Methods: All patients with CHD ages 6- 18 years old referred to pediatric pulmonology for preoperative risk stratification were included in the study. The presence and onset of upper respiratory infection was noted. FeNO determination was done and patients were grouped to low flow and high flow congenital cardiac disease. Wheezing postoperatively was observed. Accuracy of FeNO was determined.
Results: Nineteen patients completed the study. There were more patients in the high flow group, mostly ventricular septal defect 52.63%. Twenty one percent had upper respiratory tract infection, of which, 75% experienced postoperative airway reactivity. The overall accuracy of FeNO in predicting postoperative airway reactivity is 78.95% with sensitivity and specificity of 75% and 80% respectively.
Conclusion: FeNO is accurate in detecting postoperative airway reactivity in children with high flow congenital heart lesions particularly those who had upper respiratory infection.