Abstract

We recommend the use of FENO in the diagnosis of eosinophilic airway inflammation (strong recommendation,moderate quality of evidence.

We recommend the use of FENO in determining the likelihood of steroid responsiveness in individuals with chronic respiratory symptoms possibly due to airway inflammation (strong recommendation, low quality of evidence.

We suggest that FENO may be used to support the diagnosis of asthma in situations in which objective evidence is needed (weak recommendation, moderate quality of evidence.

We suggest the use of cut points rather than reference values when interpreting FENO levels (weak recommendation,low quality of evidence.

We recommend accounting for age as a factor affecting FENO in children younger than 12 years of age (strong recommendation, high quality of evidence.

We recommend that low FENO less than 25 ppb (<20 ppb in children) be used to indicate that eosinophilic inflammation and responsiveness to corticosteroids are less likely (strong recommendation, moderate quality of evidence.

We recommend that FENO greater than 50 ppb (>35 ppb in children) be used to indicate that eosinophilic inflammation and, in symptomatic patients, responsiveness to corticosteroids are likely (strong recommendation, moderate quality of evidence.

We recommend that FENO values between 25 ppb and 50 ppb (20–35 ppb in children) should be interpreted cautiously and with reference to the clinical context. (strong recommendation, low quality of evidence).

We recommend accounting for persistent and/or high allergen exposure as a factor associated with higher levels of FENO (strong recommendation, moderate quality of evidence.

We recommend the use of FENO in monitoring airway inflammation in patients with asthma (strong recommendation, low quality of evidence.

We suggest using the following values to determine a significant increase in FENO: greater than 20% for values over 50 ppb or more than 10 ppb for values lower than 50 ppb from one visit to the next (weak recommendation, low quality of evidence.

We suggest using a reduction of at least 20% in FENO for values over 50 ppb or more than 10 ppb for values lower than 50 ppb as the cut point to indicate a significant response to antiinflammatory therapy (weak recommendation,low quality of evidence).

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