Abstract
Exhaled nitric oxide levels were first discovered to be elevated in patients with asthma in 1993, only 2 years after the first National Heart Lung and Blood Institute (NHLBI) asthma guidelines were published. 1 Alving K Weitzberg E Lundberg JM. Increased amount of nitric oxide in exhaled air of asthmatics. Eur Respir J. 1993; 6: 1368-1370 PubMed Google Scholar Since then, more than 3600 articles have been published relating to the measurement of fractional exhaled nitric oxide (FeNO) in asthma, with an average of almost 20 articles per month being published over the past 10 years. Despite our growing understanding of the use of FeNO as a tool to assist in the evaluation and management of asthma, it has seen a particularly slow uptake among practitioners in the United States, especially in comparison to its wider acceptance and uses in other parts of the world including the United Kingdom and European Union. In 2011, the American Thoracic Society published evidence-based guidelines on the clinical use of FeNO 2 Dweik RA Boggs PB Erzurum SC Irvin CG Leigh MW Lundberg JO et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011; 184: 602-615 Crossref PubMed Scopus (1677) Google Scholar ; however, the regularly updated international Global Initiative for Asthma guidelines did not adopt or endorse these recommendations at that time. 3 Global Initiative for Asthma. Global strategy for asthma management and prevention. 2020. Available at: http://www.ginasthma.org. Accessed September 25, 2021. Google Scholar The lack of consensus guidelines has, in part, been responsible for the slow adoption of FeNO by practitioners as a unique, clinically meaningful, and important tool in the diagnosis and management of asthma, and this has also led to several third-party payers denying payment and citing its use as “experimental.”
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.