# Electrochemical nasal nitric oxide measurement during laryngeal mask ventilation as primary ciliary dyskinesia screening

## TL;DR

A new electrochemical method for measuring nasal nitric oxide shows promise for diagnosing a rare genetic disorder in young children.

## Contribution

A novel electrochemical technique for nasal nitric oxide measurement in children under 5 during laryngeal mask ventilation is introduced.

## Key findings

- The technique showed high repeatability with an ICC of 0.974 in children under and over 5 years.
- The coefficient of variation was 0.116, comparable to established chemiluminescence methods.
- The method is feasible for young children and may simplify PCD diagnosis.

## Abstract

Diagnosis of primary ciliary dyskinesia (PCD) can be challenging, especially in children of preschool age. Measurement of nasal nitric oxide (nNO) production helps in making the diagnosis. While chemiluminescence-based nNO measurement is sufficiently established, measuring nNO using electrochemical devices is common in older patients, although data on their repeatability and accuracy are scarce.

This is a retrospective analysis of nNO measurements using an electrochemical technique (ECnNO) in 52 children undergoing bronchoscopy including 10 PCD cases. Using a novel approach to obtain electrochemical measurements in even very young children (n=31) (59.6%) were <5 years of age), ECnNO was measured while patients were in breath-hold during ventilation with laryngeal mask (ECnNO LAMA). For agreement, the intraclass correlation coefficient (ICC) was calculated. Precision is described by the measurements’ coefficient of variation.

ECnNO LAMA measurements yielded an overall substantial ICC of 0.974 (95% CI 0.972–0.990) with no statistical difference for patients over or under 5 years. The overall coefficient of variation was 0.116 and thus comparable to chemiluminescence-based measurements in this age group.

The novel ECnNO LAMA technique is feasible and showed promising repeatability and precision in screening for PCD in children <5 years of age. While further studies are needed, this method may help diagnose PCD in young patients and simplify a troublesome differential diagnostic process.

Novel electrochemical NO measurement during laryngeal mask ventilation showed promising repeatability and precision in screening for PCD in children <5 years. This may help diagnose PCD in young patients and simplify differential diagnostics.
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