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A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
05:46

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Published on: May 4, 2021

Breathing Out the Truth: What Fractional Exhaled Nitric Oxide Really Tells Us About Pediatric Asthma

Adriana Mihai1,2, Ileana Katerina Ioniuc1,2, Alina Mariela Murgu1,2

  • 1Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania.

Diagnostics (Basel, Switzerland)
|June 12, 2026
PubMed

Insights

Fractional exhaled nitric oxide (FeNO) aids in diagnosing and managing pediatric asthma when lung function tests are difficult. This biomarker offers valuable insights for treatment and monitoring, improving precision in care.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Biomarker Research

Background:

  • Childhood asthma diagnosis and monitoring present challenges, especially in young children.
  • Objective assessment of airway inflammation is crucial but often limited by conventional methods.
  • Fractional exhaled nitric oxide (FeNO) is an emerging tool for evaluating airway inflammation.

Purpose of the Study:

  • To review the clinical utility of FeNO in pediatric asthma.
  • To assess FeNO's role in diagnosis, treatment guidance, and disease monitoring.
  • To evaluate FeNO as a complementary biomarker in childhood asthma management.

Main Methods:

  • A narrative review of studies published between January 2015 and October 2025.
  • Literature search conducted in PubMed using keywords related to FeNO, asthma, and pediatrics.
  • Inclusion of 47 studies after applying eligibility criteria.

Main Results:

  • FeNO demonstrates moderate-to-good diagnostic accuracy for childhood asthma (sensitivity 0.79, specificity 0.81).
  • FeNO-guided therapy may decrease exacerbations in some pediatric patients, but effects on symptoms and steroid use are inconsistent.
  • Serial FeNO measurements can inform inflammatory control, adherence, and exacerbation risk, though influenced by confounding factors.

Conclusions:

  • FeNO is a valuable complementary biomarker for pediatric asthma, enhancing diagnostic and therapeutic precision.
  • Optimal use of FeNO requires integration into a multimodal clinical approach, not as a standalone tool.
  • Further research may clarify FeNO's role in specific asthma phenotypes and treatment strategies.

Keywords:
FeNOasthma diagnosisasthma monitoringfractional exhaled nitric oxideinhaled corticosteroidspediatric asthma

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