Practical points on using NIOX MINO fractional exhaled nitric oxide (FENO) measuring device

The practical points below represent a summary from a presentation on the FENO measurement device NIOX MINO. They were initially posted on Twitter as text messages.

- NiOX Mino requires daily biological calibration in the U.S., required by FDA, not in Europe. The initial calibration of NiOX Mino takes 4 days, if regular calibration is not performed, the device "locks you out."


NIOX MINO display. The device needs to be plugged in at all times.


NIOX MINO - the patient's side of the device.

- NiOX Mino's display is on the back of the device - it requires a mirror to see the indicator "cloud" when you are using the device.


The display is on the back of the device - it requires a mirror to see the indicator "cloud" when using it.


The "cloud" indicator.

- When exhaling into the NiOX Mino device, it indicates a correct maneuver by emitting a sound similar to a Scottish bag pipe.

- The ATS guidelines require an one hour interval between eating or drinking and FeNO measurement.

- NiOX Mino FeNO cutoff point for "normal" value is 20 - similar to ACT. Difference: FeNO greater than 20 implies poor control, ACT greater than 20 implies good control.

The cost of device: $2,500, 100-test sensor/100 mouth pieces: $1,600, 300-test sensor: $3,400. The sensor lasts 9 months. Unsuccessful test maneuvers don't "use up" the sensor which lasts only 300 measurements.

- A replacement sensor costs $3,400 - the cost of each test is $17 - the reimbursement is $16.


Individual mouth pieces that must be used with NIOX MINO. Each extra mouth piece costs $4. The mouth pieces are included with the purchase of a sensor for 100 or 300 tests.


Inflammation in asthma (mind map). FeNO is a marker of oxidative stress. See more Allergy and Immunology mind maps here.

However, a 2012 study in the journal Thorax, showed that tailoring of asthma treatment based on FeNO levels was ineffective in improving outcomes in children and adults.


References:
FDA Approves NIOX MINO for Asthma Monitoring. Medgadget, 2008.
Allergic asthma associated with increased FeNO, but only in never-smokers
Exhaled nitric oxide (FeNO) in asthma and sinusitis

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