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Measuring FeNO

Follow this guide on how to perform a FeNO test using NIOX VERO®, the device of choice for FeNO testing:1

1. Switch on your FeNO analyser

Switch on your device by pushing the button on the left of the device to the on position.

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2. Attach a new mouth filter.

Attach a new mouth filter to the breathing handle for each patient, mouth filters have ≥99.99% bacterial filtration efficiency and ≥99.97% viral filtration efficiency to prevent the spread of germs.

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3. Ask the patient to fully empty their lungs.

Ensure the patient empties thier lungs fully so they are prepared for the next step.

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4. The patient inhales through the breathing handle for three seconds.

Inhaling through the breathing handle for 3 seconds is a crucial step as it ensures ambient nitric oxide is removed from the measurement.

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5. The patient then exhales through the breathing handle.

Exhalation takes 10 seconds at a steady flow rate. A 6-second mode is available for children aged 4-10 who are unable to perform the 10-second test. The device will help the patient to maintain a steady flow using animation and sound.

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6. Once the test is complete, the device will analyse the breath sample.

This is where the magic happens! During the analysis phase the device putting everything together to ensure an accurate result is generated.

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7. The FeNO result will be displayed in approximately one minute.

Once the test is complete you will have an accurate and reliable FeNO test result.

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The NIOX VERO® FeNO testing device displaying a FeNO test result of 50ppb

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References:

1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. 2021 update. 2. Kavanagh J et al. Over- and under-diagnosis in asthma. Breathe (Sheff). 2019;15(1):e20-e27. 3. Wang Z et al. Agency for Healthcare Research and Quality (AHRQ). The clinical utility of fractional exhaled nitric oxide (FeNO) in asthma management. Comparative Effectiveness Reviews, 197. 2017. 4. Petsky HL et al. Tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils): a systematic review and meta-analysis. Thorax. 2018;73(12):1110-1119. 5. Dweik RA et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FeNO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602-15. 6. NIOX®. Data on File; MKT-DOF-007. 2023. 7. Menzies-Gow A et al. Clinical utility of fractional exhaled nitric oxide in severe asthma management. Eur Respir J. 2020;55(3):1901633. 8. NIOX®. NHS England Asthma data 2022 (AST001). QOF database. Available at; https://www.gpcontract.co.uk/browse/ENG/Asthma/22. Accessed; May 2023.

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