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fraction of exhaled nitric oxide (FeNo)

Indications: - aid in the diagnosis of asthma [NGC, NICE] - evaluation of non-asthmatic eosinophilic bronchitis - aid in the prediction of response to inhaled glucocorticoids* [3] * FeNo levels > 50 ppb correlate with eosinophil-associated airway inflammation & predict response to inhaled glucocorticoids [3] * FeNo levels < 25 ppb make eosinophil-associated airway inflammation & response to inhaled glucocorticoids less likely [3] Contraindications: - not for determining treatment of asthma in the general population [3] Clinical significance: Exhaled nitric oxide reflects: 1) bronchial wall inflammation 2) airway hyperresponsiveness 3) induced sputum eosinophilia Increases: - asthma inadequately controlled - non-asthmatic eosinophilic bronchitis

General

pulmonary function test (PFT)

References

  1. Smith AD et al, Use of exhaled nitric oxide measurements to guide treatment in chronic asthma. N Engl J Med 352:2163, 2005 PMID: 15914548
  2. Wang Z, Pianosi P, Keogh K et al Agency for Healthcare Research and Quality (AHRQ) The Clinical Utility of Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management. Comparative Effectiveness Review No. 197. Dec 20, 2017 https://www.effectivehealthcare.ahrq.gov/topics/asthma-nitric-oxide/research
  3. Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022