Abstract
OBJECTIVE: To measure levels of 8-isoprostane and Lipoxin A4 in the exhaled breath condensate of children (7-17 yrs old) recovering from status asthmaticus in a pediatric intensive care unit and to compare their respective levels in the exhaled breath condensate collected from age-matched "healthy" children enrolled from an ambulatory pediatric clinic during well-child visits. DESIGN: Prospective case-controlled study. SETTING: Teaching hospitals and a research laboratory. PATIENTS: Children recovering from status asthmaticus and age-matched controls. INTERVENTIONS: Collection of exhaled breath condensate from patients recovering from status asthmaticus and controls for purpose of measurement of 8-isoprostane and Lipoxin A4. MEASUREMENTS AND MAIN RESULTS: There was no difference in age (11.9 ± 3.0 vs. 12.0 ± 3.3 yrs, p = .9) between patients and control subjects. All participants completed the exhaled breath condensate collection without complications. There was no difference in the pulmonary index (3.3 ± 2.2 vs. 3.1 ± 1.9, p = 1.0) after collection of exhaled breath condensate compared with baseline values in patients with status asthmaticus. The level of 8-isoprostane was significantly higher (63 ± 9 vs. 41 ± 13 pg/mL, p < .001), whereas the level of Lipoxin A4 was significantly lower (5.6 ± 2.9 vs. 10.5 ± 3.1 ng/mL, p < .001) in the exhaled breath condensate from children recovering from status asthmaticus compared with control subjects. CONCLUSIONS: 8-Isoprostane was elevated and Lipoxin A4 is decreased in the exhaled breath condensate of children recovering from status asthmaticus in a pediatric intensive care unit. These data may provide new insight into the pathophysiology of asthma in children in this clinical setting.