Exhaled carbon monoxide: variations due to collection method and physiology.

IF 3.7 4区 医学 Q1 BIOCHEMICAL RESEARCH METHODS
Shahriar Arbabi, Eric P Smith, Jacob J Fondriest, Nagako Akeno, Robert S Franco, Robert M Cohen
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Abstract

The measurement of exhaled carbon monoxide (eCO) is relevant to understanding normal physiology and disease states but has been limited by deficiencies in valid sampling protocols, accurate and feasible measurement methods, and the understanding of normal physiological variation. The purposes of this study were (1) to compare the three collection methods for eCO and (2) to gain a better understanding of patterns of normal variation by obtaining repeated daily and weekly measurements. We compared three techniques to sample eCO: continuous breathing(ConB), breath-holding(BrH), and short rebreathing (SrB). We used a Carbolyzer mBA-2000 instrument that involves an electrochemical method to quantify CO, with the final value corrected for ambient CO. InPhase I, we comparedConBwithBrHin 10 healthy non-smokers (5 male, five female). On day 1, the eCO was determined from 07:30 to 17:00 (11 samples), and the first four morning time points were repeated on days 7, 14, and 21.ConBhad a lower eCO thanBrH,and eCO2was frequently below the threshold of 4.6% compatible with inadequate alveolar sampling. The eCO measured by theConBandBrHmethods increased during the day and showed week-to-week variability. InPhase II, we compared theBrHandSrBtechniques by collecting prebreakfast samples weekly for four weeks in 30 healthy non-smokers (15 male,15 female). Comparing theSrBvs. theBrHmethod,SrBwas the easier for the participants to perform, generated higher eCO (∼ 0.5 ppm), and produced higher eCO2 levels (5.2% ± 0.3 vs. 5.0% ± 0.2); Importantly,Phase IIstudy revealed that week-to-week changes in prebreakfast fasting eCO for individual participants were ⩾1.0 ppm in ∼ 37%. This variability complicates the interpretation of the relationship between small changes in eCO and the underlying physiological or disease states.

呼出的一氧化碳:由于收集方法和生理的变化。
呼出一氧化碳(eCO)的测量与了解正常生理和疾病状态有关,但由于缺乏有效的采样方案、准确可行的测量方法以及对正常生理变化的理解而受到限制。本研究的目的是:(1)比较eCO的三种收集方法;(2)通过每日和每周的重复测量来更好地了解正常变化的模式。我们比较了三种方法:连续呼吸(ConB)、屏气(BrH)和短时间再呼吸(SrB)。我们使用了Carbolyzer mBA-2000仪器,该仪器包括电化学方法来量化CO,并根据环境CO校正了最终值。在第一阶段,我们比较了10名健康非吸烟者(5名男性,5名女性)的ConB和BrH。在第1天,从0730到1700(11个样本)测定eCO,并在第7、14和21天重复前4个早晨时间点。ConB的eCO低于BrH, eCO2经常低于4.6%的阈值,这与肺泡采样不足相一致。ConB和BrH方法测得的eCO在白天增加,并表现出周变化。在第二阶段,我们通过每周收集30名健康非吸烟者(15名男性,15名女性)的早餐前样本来比较BrH和SrB技术,为期四周。SrB法与BrH法比较,SrB法更容易被试执行,产生更高的eCO (~0.5 ppm),产生更高的eCO2水平(5.2%±0.3 vs 5.0%±0.2);重要的是,II期研究显示,个别参与者早餐前禁食eCO的周变化≥1.0 ppm,占37%。这种可变性使对eCO微小变化与潜在生理或疾病状态之间关系的解释复杂化。
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来源期刊
Journal of breath research
Journal of breath research BIOCHEMICAL RESEARCH METHODS-RESPIRATORY SYSTEM
CiteScore
7.60
自引率
21.10%
发文量
49
审稿时长
>12 weeks
期刊介绍: Journal of Breath Research is dedicated to all aspects of scientific breath research. The traditional focus is on analysis of volatile compounds and aerosols in exhaled breath for the investigation of exogenous exposures, metabolism, toxicology, health status and the diagnosis of disease and breath odours. The journal also welcomes other breath-related topics. Typical areas of interest include: Big laboratory instrumentation: describing new state-of-the-art analytical instrumentation capable of performing high-resolution discovery and targeted breath research; exploiting complex technologies drawn from other areas of biochemistry and genetics for breath research. Engineering solutions: developing new breath sampling technologies for condensate and aerosols, for chemical and optical sensors, for extraction and sample preparation methods, for automation and standardization, and for multiplex analyses to preserve the breath matrix and facilitating analytical throughput. Measure exhaled constituents (e.g. CO2, acetone, isoprene) as markers of human presence or mitigate such contaminants in enclosed environments. Human and animal in vivo studies: decoding the ''breath exposome'', implementing exposure and intervention studies, performing cross-sectional and case-control research, assaying immune and inflammatory response, and testing mammalian host response to infections and exogenous exposures to develop information directly applicable to systems biology. Studying inhalation toxicology; inhaled breath as a source of internal dose; resultant blood, breath and urinary biomarkers linked to inhalation pathway. Cellular and molecular level in vitro studies. Clinical, pharmacological and forensic applications. Mathematical, statistical and graphical data interpretation.
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