Paediatric Respiratory Reviews
Volume 9, Issue 2 , Pages 122-126, June 2008

The value of FeNO measurement in asthma management: the motion against FeNO to help manage childhood asthma – reality bites

  • Peter J. Franklin

      Affiliations

    • Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, Perth, Western Australia
    • ,
  • Stephen M. Stick

      Affiliations

    • Respiratory Medicine Department, Princess Margaret Hospital for Children, Perth, Western Australia
    • School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia
    • Corresponding Author InformationCorresponding author. Respiratory Medicine Department, Princess Margaret Hospital for Children, GPO Box D1840, Perth, Western Australia 6840. Tel.: +61 8 93408986; Fax: +61 8 93408181.

Summary 

Since exhaled nitric oxide (FeNO) was first demonstrated to be raised in asthmatic patients in the early 1990s, there has been a strong interest in its potential role in the diagnosis and management of asthma. This culminated in 2003 when the US Food and Drug Administration cleared the NIOX nitric oxide analyser for clinical application in patients with asthma. The interest in FeNO is based on the assumptions that FeNO is a marker of asthma and asthma control, and that it reflects eosinophilic airway inflammation. However, the literature remains unconvincing and inconclusive. Furthermore, studies which have management algorithms that include FeNO as a guide to asthma treatment have failed to observe any improvement in asthma control compared with the use of standard asthma guidelines. At present, the cost of including FeNO in management guidelines far outweighs any potential benefits.

Keywords: exhaled nitric oxide, asthma diagnosis, asthma management, eosinophils, atopy

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PII: S1526-0542(07)00135-2

doi:10.1016/j.prrv.2007.12.004

Paediatric Respiratory Reviews
Volume 9, Issue 2 , Pages 122-126, June 2008

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