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.
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