There is a growing interest in exhaled nitric oxide (NO) as a non-invasive marker of pulmonary inflammation and oxidative stress. Previous studies has focused on use of exhaled NO to diagnose and monitor the airway inflammation in spontaneously breathing patients, However, few studies have involved mechanically ventilated (MV) patients. Airway inflammation and oxidative stress during MV tend to predispose to more serious complications, such as acute lung injury. Thus exhaled NO analysis may also have a potential use in MV patients. As an initial step, it is necessary to explore changes in levels of exhaled NO and its serum marker (serum nitrite [sNOa""""""""- ]) over time in patients who require an artificial airway (which disrupts normal NO flow from the nose to the lower airways) and MV (which introduces confounding factors). The purpose of this study is to examine changes in exhaled NO from the nose (nNO), exhaled NO from the lower ariways (LNO) and sNO2~ over time in: 1) spontaneously breathing patients undergoing tracheostomy or laryngectomy (T/L), and 2) patients undergoing tracheostomy while on MV (T-MV). A prospective, 2x3 repeated measures design will be used. Comparisons will be made between nNO, LNO and sNC>2~ obtained 1) pre-T/L, Day 1-3 post-T/L, and 1 week after in T/L patients, and 2) pre-tracheostomy, Day 1-3 post-tracheostomy, and 1 week after in T-MV patients. Statistical analysis will include descriptive statistics, 2x3 repeated measures MANCOVA, one wav repeated measures ANOVA and Soearman's rank correlation.
| Cuevas, Christian D; Lavanya, Madakasira; Wang, Enxiu et al. (2011) Junin virus infects mouse cells and induces innate immune responses. J Virol 85:11058-68 |
| Choi, J; Hoffman, L A; Sethi, J M et al. (2009) Multiple flow rates measurement of exhaled nitric oxide in patients with sarcoidosis: a pilot feasibility study. Sarcoidosis Vasc Diffuse Lung Dis 26:98-109 |
| Rodway, G W; Choi, J; Hoffman, L A et al. (2009) Exhaled nitric oxide in the diagnosis and management of asthma: clinical implications. Chron Respir Dis 6:19-29 |
| Choi, JiYeon; Tasota, Frederick J; Hoffman, Leslie A (2008) Mobility interventions to improve outcomes in patients undergoing prolonged mechanical ventilation: a review of the literature. Biol Res Nurs 10:21-33 |
