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FeNO Guidelines

Updated asthma guidelines reflect the increasing amount of literature evidence that describes the value of FeNO monitoring in asthma management.1


In September 2011, the American Thoracic Society (ATS) published a clinical practice guideline on the Interpretation of Exhaled Nitric Oxide Levels (FeNO) for Clinical Applications: an official ATS Clinical Practice Guideline. This practice guideline was designed for clinicians and provided evidence-based recommendations for the use and interpretation of exhaled nitric oxide measurements in clinical practice.


Most recently, the Global Initiative for Asthma (GINA) was also updated and includes recommendations for FeNO use.

ACAAI & AAAAI Joint Statement of Support

The ATS guideline was also formally endorsed and supported by the American College of Allergy, Asthma and Immunology (ACAAI) and the American Academy of Allergy, Asthma and Immunology (AAAAI).


In the US, the National Institute for Health (NIH) Agency for Healthcare Research and Quality (AHRQ) published an extensive evidence-based review of FeNO which supports its use in the diagnosis and management of asthma.


FeNO has also been included in the most recent asthma guidelines in the United Kingdom; the National Institute for Health and Care Excellence (NICE) recommends FeNO to help diagnose and manage asthma in adults and children.

NICE have also created an implementation resource for Primary Care.


References: 1. Arnold RJ, Massanari M, Lee TA, Brooks E. A Review of the Utility and Cost Effectiveness of Monitoring Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management. Manag Care. 2018 Jul;27(7):34-41.