Comparability of a hand-held nitric oxide analyser with online and offline chemiluminescence-based nitric oxide measurement

Pediatr Allergy Immunol. 2009 Nov;20(7):679-85. doi: 10.1111/j.1399-3038.2009.00853.x. Epub 2009 Aug 13.


Practicability is crucial for successful implementation of fractional exhaled nitric oxide (FeNO) measurement into asthma management. The study aimed at comparing a conventional chemiluminescence NO analyser (EcoMedics) with a hand-held device (NIOX MINO) and offline FeNO measurement using a commercially available system in an unselected cohort of children aged 6-16 yr. A secondary objective was to confirm FeNO stability over time in 15 samples from adult volunteers obtained using the offline system. Sixty-six children (mean +/- s.d. age 11.8 +/- 3.0 yr) underwent single breath FeNO measurement in triplets with each device. Offline collected FeNO was measured after offline breath collection into a Mylar balloon and subsequent analysis using the chemiluminescence NO analyser. Variability and between-method agreement were assessed, and stability over time within the Mylar balloons was tested by repeated hourly measurements. FeNO levels ranged from 2 to 113 p.p.b. Intra-class correlation was excellent (r = 0.98, p < 0.001 for each pair). Bland-Altman plots and back-transformation of logarithmic mean differences revealed fair agreement between methods. Stability over time was confirmed over 10 h both at room temperature and when stored under cooling conditions. FeNO values obtained using the chemiluminescence NO analyser, the portable NIOX MINO system and the offline collection technique show between-method agreement within clinically acceptable range.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Asthma / physiopathology*
  • Breath Tests / instrumentation*
  • Breath Tests / methods
  • Child
  • Electrochemistry / methods
  • Equipment Design
  • Exhalation
  • Female
  • Humans
  • Luminescent Measurements / instrumentation*
  • Luminescent Measurements / methods
  • Male
  • Monitoring, Physiologic / instrumentation*
  • Monitoring, Physiologic / methods
  • Nitric Oxide / analysis*
  • Reference Values
  • Reproducibility of Results


  • Nitric Oxide