How do I use NIOX VERO®?

NIOX VERO® makes measuring airway inflammation safe and easy. The small, portable device has been designed with both healthcare professionals and patients in mind, and boasts several smart features to make FeNO testing a breeze. We believe in keeping it simple so here’s a quick guide.

There are a couple of things to consider before taking a FeNO measurement:

How old is the patient? Sometimes, younger patients can’t continuously exhale for ten seconds. However, this is the optimum time so if they can manage it, they should. If they’re unable to manage a ten-second exhalation, the 6-second mode is an alternative. The six-second test should be used with caution in patients over the age of 10. It should not be used in adult patients. Incorrect use of the 6-second exhalation test may result in falsely low FeNO values, which can lead to incorrect clinical decisions.
Once you’ve selected the six or ten-second mode, follow the steps below to complete the test. Remember, NIOX VERO® protects your patients from failing a test – the device will only display a measurement following a successful FeNO test.

Performing a FeNO test with NIOX VERO®

Step 1: Make sure your device is switched on. If it’s in sleep or standby mode, touch the screen to wake it.

Step 2: Give the device a basic check to make sure it’s working properly and hasn’t been damaged. You should also make sure the device is in normal operating conditions:

Don’t place the device in direct sunlight, sources of heat or ventilation
Make sure the location temperature is +10-35⁰C (+50-95⁰F)
Relative humidity in the operating environment should be 20-80%, non-condensing

Step 3: Register your patient ID. This is optional and should be used if you’re storing records on the device or if the device is operating as a standalone instrument but will later be synced to a NIOX® Patient database. Enter the patient’s ID every time, before you start to perform a FeNO test, even if it’s the same patient. Please consider local regulations on patient data when using unique identifiers.

Select Register Patient ID from the main menu
Enter up to 12 characters
Select the ABC button to activate the alphabetic keyboard. 123 changes the view back to numeric
Press OK to confirm
To make changes after pressing the confirmation, touch the Register Patient ID button and use delete to erase text and make the change or remove the ID
Erase looks like this
Undo a registration looks like this

Step 4: Using a new mouth filter for each patient, attach the filter to the breathing handle. To do this, just remove the breathing handle’s cap and twist the filter on until you hear it click into place – there’s a risk of leakage if it’s not fully attached, which would give an incorrect FeNO measurement. Please don’t open the patient filter packaging using anything sharp and remember not to touch the filter membrane. Filters should be used immediately after opening.

Step 5: Pass the breathing handle to the patient.

First, the patient should breathe out and fully empty their lungs
Next, ask the patient to place the breathing handle in their mouth, keeping the lips securely around the mouthpiece
The patient should then inhale deeply through the filter to total lung capacity. The handy animations on the display will move upwards while they inhale
Finally, when the animation stops moving upward during their inhalation, you can ask the patient to breathe out steadily for the 6- or 10-second period you’ve selected. A choice of animations on the NIOX VERO® screen or the larger NIOX® Panel display will guide the patient in maintaining a steady rate of airflow – for example, depending on the animation selected, they simply aim to keep the cloud/the needle/the balloon within the upper and lower limits shown as white lines on the screen. If the pressure is wrong, the cloud/the needle/the balloon will move out of the limits and an audible warning will sound.

Note: The patient filter should remain on the breathing handle during the analysis phase of the measurement. If the patient filter is removed during the analysis, it could generate an alert and require the patient to perform the measurement again.

How do I start the test?
The process begins when the patient inhales air from the handle or you can press the Start Measurement button.

How long does the device remain active before entering standby or sleep mode?
The NIOX VERO® enters sleep or standby mode after an inactive period of:

Power source	Display dims	Standby	Sleep (reboots when reactivated)
Mains (AC)	1 minute	4 minutes	NA
Battery	30 seconds	2 minutes	17 minutes

How many FeNO measurements can the NIOX VERO® take in one session?
Up to 10 exhalations can be performed in one hour. However, if the device is paused for at least 30 minutes, it can test up to 20 exhalations in the same hour. Exhalations include successful and failed attempts.

Why can’t I perform more tests in one hour?
Exhaled breath contains water vapour, which can condense inside the device, so it’s best to give it a break to avoid condensation build-up.

Can I clean and re-use the patient filters?
No. Each patient should be given a fresh filter to avoid cross-infection. Of course, it’s fine to use the same filter for more than one FeNO test on the same patient during the same visit.

How do I store unused patient filters?
Patient filters can be stored in their original box.

I’m running out of filters. How do I buy more?
Your local sales contact can arrange a delivery for you. Click here to contact your regional representative and they’ll do the rest.