What is FeNO?

FeNO (Fractional exhaled Nitric Oxide) are very miniscule particles of the gas Nitric Oxide (NO), measured in parts per billion. NO is naturally produced by your body to help combat inflammation and when your airway is inflamed, NO is produced in the lungs and exhaled on the breath.

The production of nitric oxide is often found to be higher in inflammatory conditions such as asthma and therefore FeNO monitoring can be used for the detection and management of such conditions2, but also to differentiate between COPD, ACOS other and interstitial lung diseases that are not assessed by other means, such as lung function3.

Airway inflammation is a central process in asthma and other lung diseases1. Being able to detect eosinophilic airway inflammation and monitor a patient’s response to treatment is regarded as a gold standard in the management of respiratory diseases.

Nitric oxide measurement is not intended as a stand-alone method for diagnosis and should be used in conjunction with other evaluation methods and tests4.
Using FeNO measurements to evaluate airway inflammation in asthma represents a significant advance in respiratory medicine5, but until now this has been an expensive test to deliver in everyday practice.

Benefits
● Non-invasive, quick and easy to perform5
● Shows patient’s response to treatment, enabling the correct prescription of medication and safer/monitored adjustments
● Shows patient compliance
● Aids in identifying patients who do/do not require on-going treatment6
● Shown to be superior to the majority of conventional tests of lung function, such as peak flow recording and spirometry5
● Aids in differentiating between allergic (eosinophillic) and non-allergic asthma7.

FeNO in Asthma?

According to asthma UK, approximately 5.4 million people in the UK, receive treatment for asthma9, and approximately 300 million individuals worldwide are thought to be affected by asthma10. It is thought that on average, 3 people die daily from asthma attacks in the UK.9It is thought that the NHS spends approximately £1 billion a year treating and managing asthma symptoms9. Asthma is commonly referred to as an inflammatory disease which affects a person’s airways, leading to hyper-responsiveness, obstruction, mucus hyper-production, and airway wall remodelling10. Although airway eosinophilic inflammation is a key characteristic of asthma, very few methods are available for measuring airway eosinophilic inflammation. Airway eosinophilic inflammation can be measured, by measuring eosinophils and eosinophilic cationic protein (ECP) in sputum, or ECP’s can be measured in a blood sample11. These methods are commonly considered gold standard, but are very time consuming, expensive, and are not commonly readily available.
A majority of asthma patient’s airway inflammation is allergen-driven Th2 response12. There is significant evidence from external literature suggesting FeNO (Nitric oxide) is a key biomarker tool for inflammation of the respiratory tract12. Increased levels of FeNO in asthma are thought to come from inducible NOS2 expressed in the inflamed airways12. NObreath offers an alternative aid to diagnose asthma, which is non-invasive, and significantly more cost effective than current gold standard methods for aiding to diagnose airway eosinophilic inflammation, further aiding in the diagnosis of asthma. As a result of substantial amounts of literature supporting FeNO measurements as an effective biomarker for asthma and other airway inflammation, FeNO breath testing is now recommended in NICE guidelines as an aid to diagnose allergic asthma13. Literature also suggests the ability for FeNO measurement to be used as good management tool for asthma14, assessing the effectiveness of treatments for patients, optimising asthma treatments.

International FeNO use

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NObreath – what is it?

The NObreath is a FeNO monitor which can be used to measure airway inflammation for the management and diagnosis of asthma. Recommended by NICE and conformed to ATS & ERS guidelines, the NObreath makes FeNO monitoring quick, and easy plus it is completely non-invasive, with the ability to monitor airway inflammation in both adult and child patients. Furthermore, the ambient monitoring mode enables you to check ambient levels of NO.
No Limits

Unlimited uses subject to maintenance and
general wear and tear

Adult and Child Modes

Adult & child patient modes for best
sampling times and quick result referrals

Easy To Use

With a simple exhale only technique
and on screen visual motivation

Patient Profiles

Ability to store x many patient profiles
and readings and view a graph of results

NObreath Monitor face on
Optimum Infection Control

We are proud to say the NObreath® monitor
is integrated with SteriTouch® antimicrobial additives,
which eradicate the bacteria that cause
contamination and infection

NObreath Dock

NObreath dock for safe and convenient
storage, charging and synchronisation

Proven Technology

The NObreath has over 10 years of clinical
use featuring in many studies worldwide

Most Cost Effective Solution

Low cost, long lifetime mouthpieces with
an efficiency rate of >99% (Bacteria) and
>98% (viruses)

As easy as…

NObreath step 1
NObreath step 2
NObreath step 3

Technical Specification

Temperature icon

Warm-up time
≤60 secs

Consumables

Our consumables are made to the highest quality at the most cost effective prices.
NObreath mouthpiece
NObreath Mouthpiece
The NObreath mouthpiece is single-patient use and
incorporates a one-way valve to prevent air being
drawn back from the monitor. The mouthpiece itself has
an integrated infection control filter which removes and
traps >99% of airborne bacteria and >98% of viruses and
any moisture from the patient’s breath8.
AZO universal wipes - pack of 50
Monitor Cleaning Wipes
Free from alcohol to ensure continued
performance of your monitor. Pack of 50
wipes.

Accreditations

We take the utmost pride in the fact that the NObreath is accredited to BS EN ISO13485:2016 and CE marked to the Medical Device Directive (MDD).
CE 0086
ISO logo

FeNOchart™

FeNOchart™ is a FREE patient management software for the NObreath FeNO monitor.
Patients can be synchronised between the NObreath and computer, enabling you to safely back-up and store patient profiles and results. The software also has the ability to capture readings directly from tests when the NObreath is plugged into the computer, plus graphs can be plotted and reports generated to share with patients and monitor FeNO levels.
Image of child blowing into the NObreath FeNO monitor

Worldwide Forum

With the purchase of a NObreath you are eligible to become a member of the NObreath® forum – a place where you can seek answers, offer help or simply discuss FeNO techniques, findings and much more with other healthcare professionals from around the world.
NObreath forum (gastro+ flyer)

Already own a NObreath?
Click here to sign up today.

Literature

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Catalogue

Papers

Method Comparison Study

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Datasheet

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Manual

News

All the latest on the NObreath and FeNO monitoring…

Where to buy?

We operate through a network of carefully selected distributors worldwide – to find your
nearest distributor, click here

Board of Clinicians

We work with a network of KOL in the respiratory world to make sure the NObreath is fit for purpose. We are always working to improve our NObreath if you would like to be a part of this elite group of Clinicians, please contact Bedfont today.

Our Mission

To help improve asthma diagnosis & management of adults and children worldwide through FeNO monitoring.

Our Purpose

To make FeNO monitoring more accessible globally, with the creation of an effective yet cost-efficient FeNO monitor and equally low cost consumables.

Customer Charter

  1. We work hard to design and manufacture the most up to date, high quality, innovative products for use by worldwide health professionals.
  2. We re-invest our profit into future research and development to keep our products up to life saving standards.
  3. We strive to produce high quality consumables at the lowest possible prices.
  4. We are committed to provide a very high level of quality customer service that takes account of the changing needs and expectations of our customers.
  5. We work to continuously improve the quality in all that we do.

The NObreath FeNO monitor is a product from Bedfont Scientific Ltd.

Our family, innovating health, for yours.

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Bedfont Scientific Ltd., Station Yard, Station Road, Harrietsham, Maidstone, Kent, ME17 1JA, England
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References

1. Shelhamer JH, Levine SJ, Wu T, Jacoby DB, Kaliner MA, Rennard SI. NIH conference: airway inflammation. Ann Intern Med 1995;123:288-304.
2. Saito J, Gibeon D, Macedo P, Menzies-Gow A, Bhavsar P, Chung K. Domiciliary diurnal variation of exhaled nitric oxide fraction for asthma control. 2017.
3. ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005; American Journal of Respiratory and Critical Care Medicine; vol. 171: 912-930;2005
4. Correlation of Exhaled Nitric Oxide, Spirometry and Asthma Symptoms: Journal of Asthma: Vol 42, No 10 [Internet]. Tandfonline.com. 2017 [cited 15 March 2017]. Available from: http://www.tandfonline.com/doi/abs/10.1080/02770900500371344

More References

5. Andrew D. Smith, Jan O. Cowan, Sue Filsell, Chris MacLachlan, Gabrielle Monti Sheehan, Pamela Jackson and D. Robin Taylor. Diagnosing Asthma: Comparisons between Exhaled Nitric Oxide Measurements and Conventional Tests. Am J Respir Crit Care Med Vol 169. pp 473-478, 2004.
6. D R Taylor, MW Pinenburg, A D Smith and J C D Jongste. Exhaled nitric oxide measurements: clinical application and interpretation. Thorax 2006;61:817-827.
7. Coumou HBel E. Improving the diagnosis of eosinophilic asthma [Internet]. Taylor and Francis online. 2017 [cited 15 March 2017]. Available from: http://www.tandfonline.com/doi/full/10.1080/17476348.2017.1236688
8. Public Health England. An Evaluation of Filtration Efficiencies Against Bacterial and Viral Aerosol Challenges. Salisbury: Public Health England; 2020