Measurement of Fractional Exhaled Nitric Oxide: Comparison of Three Different Analysers.

Abstract

BACKGROUND:

Fractional exhaled nitric oxide (FeNO) is a surrogate marker for airway inflammation, supporting the diagnostic pathway and treatment decisions for asthma patients.

OBJECTIVES:

Aim of this study was to compare the new analyser Vivatmo pro (Bosch, BV) with NIOX VERO (Circassia, CN) and CLD (Ecomedics, EC).

METHODS:

In 100 asthmatics (median 53 years [range 20-87], 62% female, 86% on inhaled corticosteroids [mean 1,300 μg beclomethasone dipropionate or equivalent], 35% treated with biologics) 2 FeNO measurements per device were performed. Additionally, the success rate to achieve a valid NO value was evaluated.

RESULTS:

Sixty-eight percent of the patients had FeNO values below 50 ppb. Median NO concentrations were 31 ppb (range 6-194) for BV, 33 ppb (9-164) for CN and 31ppb (7-353) for EC. Bland-Altman plots suggested an agreement within the predefined limits of ±5 ppb for all analysers within the therapeutically relevant range (0-70 ppb). The highest agreement in FeNO levels were between BV and EC with mean differences of -0.26 (95% CI -1.48 to 0.95) vs. 1.52 (95% CI 0.4-2.6) ppb for CN and EC. The results indicate an equivalence of the methods (two-one sided t test-equivalence test: p < 0.0001, ±5 ppb margins). Acceptance of the measurements was high for all devices (97%). The highest success rate to obtain 2 valid NO values without failed attempts was achieved with the BV analyser (73 vs. 62% for the CN analyser and 46% for the EC analyser).

CONCLUSIONS:

For the range between 0 and 70 ppb, FeNO concentrations measured with all 3 devices were statistically equivalent within predefined acceptance criteria and did not differ in a clinically relevant way.

• Authors: Stephanie Korn, Maike Wilk, Stefanie Voigt, Stephan Weber, Thomas Keller, Roland Buhl
• Journal: Respiration; international review of thoracic diseases (Respiration) Vol. 99 Issue 1 Pg. 1-8 ( 2020) ISSN: 1423-0356 [Electronic] Switzerland
• PMID: 31288246 (Publication Type: Comparative Study, Journal Article)
• Copyright: The Author(s). Published by S. Karger AG, Basel.

Chemical References

• Anti-Asthmatic Agents
• Nitric Oxide

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Asthmatic Agents (therapeutic use)
• Asthma (drug therapy, metabolism, physiopathology)
• Breath Tests (instrumentation)
• Female
• Forced Expiratory Volume
• Humans
• Male
• Middle Aged
• Nitric Oxide (analysis)
• Vital Capacity
• Young Adult