Comparison of two exhaled nitric oxide analyzers: The NIOX MINO hand-held electrochemical analyzer and the NOA280i stationary chemiluminescence analyzer

Abstract

Background and objective: Measurement of the fraction of nitric oxide (FeNO) in exhaled air is useful in the management of asthma. A new hand-held nitric oxide (NO) analyzer, the NIOX MINO, is simple and easy to use in clinical practice. In this study, FeNO values measured using the NIOX MINO were compared with those obtained using a stationary chemiluminescence analyzer, the Sievers NOA280i. Methods: FeNO was measured in 100 adults, using both the NIOX MINO and the NOA280i. Nine (9.0%) of these subjects had asthma. The first acceptable measurement with the NIOX MINO and the mean of two acceptable measurements with the NOA280i were compared. Results: There was a significant correlation between FeNO concentrations measured with the two devices (r = 0.876, P < 0.001). A BlandAltman plot showed a high degree of agreement between the two devices: the mean inter-device difference was 3.3 parts per billion (ppb), and the 95% limits of agreement were -7.0 and 13.6 ppb. In addition, the mean relative difference was 14.5%, with the 95% limits of agreement being -33.7 and 62.7%. The mean value (+/- standard error of the mean) for FeNO as measured with the NIOX MINO (18.8 +/- 0.9 ppb) was significantly lower than that measured with the NOA280i (22.1 +/- 1.2 ppb, P < 0.001). Conclusions: There was a significant correlation, but only moderate agreement, between FeNO values measured with the NIOX MINO and those measured with the NOA280i, with the NIOX MINO values being significantly lower than the NOA280i values. Significant differences in FeNO values obtained with these two NO analyzers should be considered when interpreting the results of FeNO measurements.