Fractional exhaled nitric oxide: is there value beyond predicting exacerbations?

摘要

It would be convenient and extraordinarily helpful if fractional exhaled nitric oxide (FENO) was predictive of future exacerbations, but as Cabral et al accurately state, the literature on this is mixed. The presence of nocturnal awakening would be my candidate for a clinical predictor of trouble to come.Given the limitation emphasized in this article of not reliably predicting exacerbations, then what value does FENO add to the management of asthma for physicians and patients? Personal clinical experience with more than 12,000 asthma encounters using FENO coupled with a reasonable familiarity with the current FENO literature suggests the following: