Nitric oxide breathing tests

[KateMoss]

Hello!

Has anyone here had the fairly new Nitric oxide breathing test which detects inflammation in the lungs.

It can then be used to see how effective steroids (Inhaled and poss oral) are in that person?

Many thanks

Kate

[Hidden]

Hi,

I have had this test as part of several lung function tests. Infact it was one of the things that shows when my asthma is bad (which peak flow does not always). I suppose you could therefore use it to monitor effectiveness of steroids but I have never used it in this way. My cons did mention that the parameters can be a bit of a grey area but I suppose that is the same for most tests.

[Hidden]

Hi Kate,

I just got discharged from hospital a few days ago and while I was in I had a FeNO test- the exhaled nitric oxide. The people in lung function were not sure why I was doing because have been on high dose pred for a few months and also had I've hydrocortisone the day before as well as inhalers and other tablets etc. my result came back as low which they said shows the melds must be working but not an accurate representations of overall control etc. it was a weird test had to look in a mirror and blow into a mouth piece while keeping a smiling cloud between two lines....not sure what the hardest part was!!

Have you done this test???? The physiologists said they like people to be off meds for 3 days before you do the text normally. Wonder what the results would show then!!

Just Tux

[KateMoss]

Hello!

Thanks Folks, no I haven't done the tests yet, booked for December.

I am on permanent prednisolone and high doses of Seretide with Flixotide added on!

My Lung function tests don't always show a good representation of my asthma we think.

Will be interesting to know what these tests show.

Yes, had read it can have grey areas regarding levels...

I doubt I could come off meds for 3 days... being a brittle asthmatic!

Kate

[Hidden]

Ive had this done every week since the end of August I think. Im not 100% convinced to be honest as on reading up on them all sorts of things affect eno - smoking lowers it for example. I found a study by the Brompton online before my admission and it said highest eno tends to be in mild/mod asthmatics on low dose ics, which fits in that when I took part in a drug trial some years back mine was about 60ppb. Since having them regularly Ive ranged from 1ppb(!) to 35ppb, tending to average around 25ppb...

[Hidden]

If I remember correctly, the study found non-asthmatics average about 12ppb and severe asthmatics on both ics and pred around 18ppb.

I find the test hard although its very simple (Im told its a bit like a breathaliser but never had to do one!) as recently Ive not been able to keep the ball anywhere near where its meant to be. This alone can affect the results. My cons wants to use this as a guide to when to stop reducing pred, but Im really not convinced its that helpful.

[Hidden]

Yeah, ive had it. I didnt find it too hard (possibly due to being an ex-woodwind player - its tough when you're struggling though) I tend to have low-ish results, but always been on pred etc which some docs seem to ignore! frustrating!!! It can be good as steroids control inflammation, so if inflammation is high it might suggest an increase, if inflammation is low you might be able to reduce dose. The trouble is with a lot of bronchospasm, a little bit of inflammation is a huge problem!

[Hidden]

Yep, have had both the exhaled nitric oxide (oral) and nasal nitric oxide test several times to monitor inflammation and steroid response.

[Hidden]

This test has been done at every clinic visit at Heartlands for about 8 years now. I agree - i am not sure how helpful a single reading is, but when they are able to build up some sort of pattern of results, they can begin to correlate that with oral steroid dose, exacerbation frequency etc etc.

[Hidden]

Hey,

I have had this test done on two different machines, one being a little (ish) hand held device that you have to keep a blue light lit and you end up boss eyed trying to stare at it whilst concentrating at the same time and the other machine that I have used is one that is on a computer and you have to try and keep a bar in the green area untill the system says its complete.

my levels have varied though, anything from 14 to 125.

they usually say that if it is below 20, then it is pretty controlle dont he steroids or that you dont really need them at that particular time, and if it is above 20 then depending on high of course would depend on the level of treatment that you are going to need, and also depending on your symptoms.

one some occasions, I have had stupidly high ENO levels, yet because I wasnt super symptomatic we decided that I wouldnt increase my steroids or be admitted for higher treatment.

I guess its another one of those things that depends on both symptoms and numbers to decide on how and what level of treatment you need.

sorry for rambling

xx

[Hidden]

I have the normal squeaky cloud FENO every four weeks but not entirely sure why as when they believe it is higher they are more guessing because I can't actually complete the test. It is quite hard and unlike all the other lfts you don't just get a rubbish reading. You have to sustain a long steady expiration with quite a bit of resistance. My scores range from high 20s to 90s. They do kind of use it and other lfts and symptoms and chest sounds to play with pred and bricanyl and other meds. Have also had the nasal one but again am always on a lot of meds and they never stop them. And have been on 50/60 pred a day for months now and was still 48 on Monday.

So Charlie, now I have flawed your helpful rambling with my imcomprehensible tripe I shall leave!!