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Updated: Jul 11, 2025
05:46
A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
4.9K
ERS technical standard: Global Lung Function Initiative reference values for exhaled nitric oxide fraction (F ENO )
Marieann Högman1, Cole Bowerman2,3, Luis Chavez3
1Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
The European Respiratory Journal
|November 16, 2023
Summary
Developing reference equations for exhaled nitric oxide (FENO) is challenging due to device variability. Standardizing FENO measurement is crucial before population reference values can be established for asthma monitoring.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Biomarkers
Background:
- Elevated exhaled nitric oxide fraction (FENO) indicates T-helper 2-driven airway inflammation.
- FENO aids in asthma diagnosis and monitoring.
Purpose of the Study:
- Derive Global Lung Function Initiative reference equations for FENO.
- Establish the upper limit of normal for FENO.
Main Methods:
- Collated and harmonized individual FENO data from multiple international sites.
- Analyzed healthy individuals' data using generalized additive models (GAMLSS).
Main Results:
- Data from 34,782 individuals (8,022 healthy) were analyzed.
- Height, age, and sex explained only 12% of FENO variability.
- FENO device type significantly impacted healthy ranges and upper limits, with substantial heterogeneity remaining even with standardized devices.
Conclusions:
- Available FENO data exhibit too much variability for a single reference equation.
- Standardization of FENO devices and measurement protocols is essential for deriving reliable population reference values.
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