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The power of portability: How FeNO came out of the lab

Did you know the world’s first FeNO testing machine was developed by the team behind NIOX®? It was 1.5m tall and 70cm wide! Our cutting-edge technology has come a long way since then. Here’s a little about the story of the FeNO evolution.

Charles Darwin was a progressive thinker. He defined evolution as “descent with modification” – the idea that future generations change over time. The same concept can be applied to NIOX®! What started out as something of a giant machine compared to the desktop devices we know today certainly put us on the path to better asthma outcomes but it needed to evolve to be really successful.

When the importance of FeNO (fractional exhaled nitric oxide) as a biomarker of airway inflammation was first discovered in the 1990s, it was a clear breakthrough in the detection and management of asthma.1 But let’s face it, the first machine was no athlete! This NIOX® predecessor lived on a trolley and had to be moved around on wheels – fine for the inventors’ laboratory but how would scientists get FeNO where it was needed most – to the people?

For FeNO to benefit as many patients as possible it was essential to make testing easier. The scientists worked hard through several generations of NIOX® technology before reaching the desktop device used around the world today – NIOX VERO®.

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NIOX VERO® is small, it has a touch screen and it combines FeNO testing and nasal NO testing in one handy device. There’s even an optional range of cases for enhanced storage and transport. NIOX VERO® also includes a breathing handle. The ATS/ERS recommendations on the standardisation of the measurement of FeNO are very clear on the need to remove ambient NO from the exhaled breath being tested.2 High levels of exogenous NO can affect FeNO results.3 NIOX VERO® is the only portable device available outside China that eliminates the impact of environmental NO by using an NO scrubber in the breathing handle.4

During testing with NIOX®, the patient inhales through the breathing handle first and the scrubber filters out the NO so the air exhaled for analysis only contains NO from the patient’s airways. This way, the FeNO value obtained gives a true picture of the level of inflammation in the lungs.

Bringing FeNO testing out of the lab and to the point-of-care has helped NIOX® achieve more than 45 million tests performed worldwide. We are proud to have led the advances in FeNO testing that have given global healthcare teams the desktop devices of today – and of the future.

If you’d like to see how FeNO testing fits in your clinic, you can use our interactive augmented reality tool to put NIOX VERO® on your desk right now! Just grab a smartphone and see it for yourself via

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1. Kharitonov SA, et al. Increased nitric oxide in exhaled air of asthmatic patients. Lancet 1994;343:133-135.
2. American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005;171(8):912-30.
3. Corradi M et al. Influence of atmospheric nitric oxide concentration on the measurement of nitric oxide in exhaled air. Thorax. 1998;53(8):673-6.
4. Data on file C-NIOX-0010. © NIOX Group plc.