A survey about knowledge of exhaled nitric oxide use among Southern Italian pulmonologists and trainees

A survey about knowledge of exhaled nitric oxide use among Southern Italian pulmonologists and trainees


  • Alessio Marinelli
  • Silvano Dragonieri Respiratory Diseases, University of Bari
  • Andrea Portacci
  • Leonardo Maselli
  • Ernesto Lulaj
  • Giovanna Elisiana Carpagnano


asthma, survey, FeNO, nitric oxide, exhaled biomarkers


Background and aim of the study. We aimed to perform a survey to evaluate the knowledge of exhaled nitric oxide (FeNO) use among a group of pulmonologists and trainees within several respiratory departments in southern Italy. Methods. All participants were asked to fulfill an online survey including 19 true or false questions about several aspects of FeNO use. The questionnaire was kept anonymous, and data were not accessible to anyone except the operators. Results. A total number of 94 surveys were collected (51 specialists, 43 trainees). The median score was 14 for both pulmonologists and trainees (IQ 25-75: 13-16 and 12-15, respectively, p=ns). No significant differences in terms of age of experience (<5 years/>5 years) were detected in the group of specialists. Among trainees, those attending the first year had lower scores compared to the second, third and fourth year (p=0.05, 0.01 and 0.05, respectively). Conclusions. Our data showed an adequate knowledge about the use of FeNO concerning the diagnosis and management of asthma. Nonetheless, the understanding of FeNO use and interpretation in relation to other respiratory conditions and co-morbidities must be improved in both specialists and trainees. Finally, as expected, first year trainees had overall less knowledge regarding FeNO.



Global Initiative for Asthma guidelines 2023. Available on www.ginasthma.org. Last consultation on 29th june 2023.

Bjermer L, Alving K, Diamant Z, et al. Current evidence and future research needs for FeNO measurement in respiratory diseases. Respir Med. 2014;108:830-841. doi:/10.1016/j.rmed.2014.02.005.

Loewenthal L, Menzies-Gow A. FeNO in Asthma. Semin Respir Crit Care Med. 2022;43(5):635-645. doi: 10.1055/s-0042-1743290.

Ceci Bonello E, Bianco R, Gouder C. Knowledge of fractional exhaled nitric oxide use among doctors working in a local respiratory department. Pneumon 2023;36:4. doi:10.18332/pne/157588.

British Thoracic Society, National Health Services Scotland. British guideline on the management of asthma: A national clinical guideline. 2003. Updated July, 2019. Scottish Intercollegiate Guidelines Network 158. Last consultation on June 5th 2023. https://www.sign.ac.uk/media/1773/sign158- updated.pdf

Ahovuo-Saloranta A, Csonka P, Lehtimäki L. Basic characteristics and clinical value of FeNO in smoking asthmatics-a systematic review. J Breath Res 2019;13(3):034003. doi:10.1088/1752-7163/ab0ece.







How to Cite

Marinelli A, Dragonieri S, Portacci A, Maselli L, Lulaj E, Carpagnano GE. A survey about knowledge of exhaled nitric oxide use among Southern Italian pulmonologists and trainees. Acta Biomed [Internet]. 2024 Jun. 21 [cited 2024 Jul. 18];95(3):e2024010. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/15030