Promising accuracy of electrochemical nasal NO measurements in general anaesthesia in screening for PCD - a pilot study

Background When suspecting PCD, clinicians face diagnostic hardships. These are reflected by largely differing diagnostic algorithms from both ERS and ATS. ERS suggests measurement of nasal NO (nNO) and high-speed video microscopy analysis (HSVMA) before electron microscopy (TEM), cell culture and genetic testing. From technical view, it is important to distinguish chemiluminiescence (CI) and electrochemical (EC) measurement techniques. ATS guidelines put initial emphasis on the age of patients and availability of chemiluminiescence (CI) technique for nNO. EC measurement is not approved in the US, thus CI is considered a gold standard for nNO measurement but is much more expensive. Thus, CI nNO measurement is not easily available to all patients with suspicion of PCD. Employing CI techniques, it is possible to acquire valid measurements within few seconds, while EC technique in breath hold requires 30s sampling time. Thus, it is acknowledged, that measurements using EC devices are more difficult to perform, even more so in smaller children. To our knowledge, data on accuracy of EC-nNO measurements in Children<5yrs is not published.