Journal of Clinical Monitoring and Computing

, Volume 18, Issue 5–6, pp 379–387

Novel hand-held device for exhaled nitric oxide-analysis in research and clinical applications

  • Tryggve Hemmingsson
  • Dag Linnarsson
  • Rudolf Gambert


Changes in expired nitric oxide (NO) occur in airway inflammation and have proved to be important in the monitoring of inflammatory disease processes such as asthma. We set out to develop a novel hand-held NO-analyzer with a performance comparable to the present more costly and complex chemiluminescence instruments. The new device is based on a specially designed electrochemical sensor, where we have developed a novel sampling and analysis technology, compensating for the relatively slow response properties of the electrochemical sensor technique. A Lowest Detection Limit in NO-analysis from reference gas tests of less than 3 ppb and a response time of 15 seconds together with an average precision in human breath measurements of 1.4 ppb were obtained. We also show an agreement with the existing ‘gold standard’ FENO measurement technique, within 0.5 ppb in a group of 19 subjects together with a high linearity and accuracy compared to reference gases. The new analyzer enables affordable monitoring of inflammatory airway diseases in research and routine clinical practice.


chemiluminescence electrochemical sensor FENO asthma monitoring 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gustafsson LE, Leone A, Persson MG, Wiklund N, Moncada S. Endogenous nitric oxide is present in the exhaled air of rabbits, guinea-pigs and humans. Biochem Biophys Res Commun 1991; 181: 852–857.CrossRefPubMedGoogle Scholar
  2. 2.
    Alving K, Weitzberg E, Lundberg JM. Increased amount of nitric oxide in exhaled air of asthmatics. Eur Respir J 1993; 6: 1368–1370.PubMedGoogle Scholar
  3. 3.
    Smith AD, Cowan JO, Filsell S, McLachlan C, Monti-Sheehan G, Jackson P, Taylor R. Comparisons between exhaled nitric oxide measurements and conventional tests. Am J Respir Crit Care Med 2004; 169: 473–478.PubMedGoogle Scholar
  4. 4.
    Payne DN, Adcock IM, Wilson NM, Oates T, Scallan M, Bush A. Relationship between exhaled nitric oxide and mucosal eosinophilic inflammation in children with difficult asthma, after treatment with oral prednisolone. Am J Respir Crit Care Med 2001; 164: 1376–1381.PubMedGoogle Scholar
  5. 5.
    Warke TJ, Fitch PS, Brown V, Taylor R, Lyons JD, Ennis M, Shields MD. Exhaled nitric oxide correlates with airway eosinophils in childhood asthma. Thorax May 2002; 57(5): 383–387.CrossRefPubMedGoogle Scholar
  6. 6.
    Kharitonov SA, Alving K, Barnes PJ. ERS Task Force Report: Exhaled and nasal nitric oxide measurements: recommendations. Eur Respir J 1997; 10: 1683–1693.CrossRefPubMedGoogle Scholar
  7. 7.
    American Thoracic Society Official Statement. Recommendations for a standardized procedure for the on-line and off-line measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide in adults and children. Am J Respir Crit Care Med 1999; 160: 2104–2117.Google Scholar
  8. 8.
    Silkoff PE, McClean PA, Slutsky AS, Suguru Wakita HG, Chapman KR, Szalai JP, Zam N. Marked flow-dependence of exhaled nitric oxide using a new technique to exclude nasal nitric oxide. Am J Respir Crit Care Med 1997; 155: 260–267.PubMedGoogle Scholar
  9. 9.
    Kharitonov SA, Gonio F, Kelly C, Meah S, Barnes PJ. Reproducibility of exhaled nitric oxide measurements in healthy and asthmatic adults and children. Eur Respir J Mar 2003; 21(3): 433–438.Google Scholar
  10. 10.
    Baraldi E, Azzolin NM, Dario C, Carra S, Ongaro R, Biban P, Zacchello F. Effect of atmospheric nitric oxide (NO) on measurements of exhaled NO in asthmatic children. Pediatr Pulmonol 1998; 26: 30–34.CrossRefPubMedGoogle Scholar
  11. 11.
    Zao Z, Buttner WJ, Stetter JR. The properties and applications of amperometric gas sensors. Electroanalysis 1992; 4: 253–266.Google Scholar
  12. 12.
    Pauling L, Robinson AR, Teranishi R, Cary P. Quantitative analysis of urine vapor and breath by gas-liquid partition chromatography. Proc Natl Acad Sci USA Oct 1971; 68(10): 2374–2376.Google Scholar
  13. 13.
    Krotoszynski B, Gabriel G, O’Neill H. Characterization of human expired air: A promising investigative and diagnostic technique. J Chromatogr Sci July 1977; 15: 239–244.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2004

Authors and Affiliations

  • Tryggve Hemmingsson
    • 1
    • 2
  • Dag Linnarsson
    • 1
  • Rudolf Gambert
    • 3
  1. 1.Sect. of Environmental Physiology, Dept. of Physiology and PharmacologyKarolinska InstitutetStockholmSweden
  2. 2.Aerocrine ABSolnaSweden
  3. 3.International Technologies Dr. Gambert GmbHWismarGermany
  4. 4.SolnaSweden

Personalised recommendations