Early predictive value of postoperative fractional exhaled nitric oxide and peripheral eosinophil counts in patients with stable asthma undergoing general anesthesia.

Abstract

Background and Objective: This study aimed to evaluate the correlation between fractional exhaled nitric oxide (FeNO) levels and peripheral blood eosinophil (EOS) counts in patients with stable asthma who were undergoing general anesthesia as well as to assess their association with postoperative acute asthma exacerbations (AAE) during the perioperative period. Method: A retrospective analysis was conducted by using perioperative clinical data from 118 patients with stable asthma who received general anesthesia in Chongqing University Fuling Hospital. Logistic regression models and receiver operating characteristic curve analysis were used to identify predictive factors for AAEs during the perioperative period. The early predictive value of FeNO levels and EOS counts for AAEs after general anesthesia was quantitatively evaluated. Results: Perioperative intubation response, elevated intraoperative peak airway pressure, postoperative arterial carbon dioxide tension, extubation time, postoperative FeNO levels, and postoperative EOS counts were significantly associated with the occurrence of AAEs (p < 0.05). Multivariate logistic regression analysis demonstrated that the area under the curve for the combined postoperative FeNO and EOS levels was 0.866, with a sensitivity of 88.5% and specificity of 80.4%. These findings indicate that the combined measurement of these biomarkers offers superior early predictive value for postoperative AAEs in patients with stable asthma. Conclusion: Postoperative measurement of FeNO and peripheral EOS counts seem to enhance the early prediction of AAEs in patients with stable asthma who were undergoing general anesthesia. The combined use of these biomarkers may offer a useful tool for early risk stratification, which supports timely implementation of preventive strategies and improved perioperative management, although further validation in larger and prospective studies is needed.