Effects of ventilation on the collection of exhaled breath in humans

2004 ◽  
Vol 96 (4) ◽  
pp. 1371-1379 ◽  
Author(s):  
Keary A. Cope ◽  
Michael T. Watson ◽  
W. Michael Foster ◽  
Shelley S. Sehnert ◽  
Terence H. Risby
Keyword(s):  
Carbon Dioxide ◽  
Carbon Monoxide ◽  
Respiration Rate ◽  
Ethanol Concentration ◽  
Rank Correlation ◽  
Inverse Correlation ◽  
Exhaled Breath ◽  
Spearman’S Rank Correlation ◽  
End Tidal ◽  
Sulfur Containing

A computerized system has been developed to monitor tidal volume, respiration rate, mouth pressure, and carbon dioxide during breath collection. This system was used to investigate variability in the production of breath biomarkers over an 8-h period. Hyperventilation occurred when breath was collected from spontaneously breathing study subjects ( n = 8). Therefore, breath samples were collected from study subjects whose breathing were paced at a respiration rate of 10 breaths/min and whose tidal volumes were gauged according to body mass. In this “paced breathing” group ( n = 16), end-tidal concentrations of isoprene and ethane correlated with end-tidal carbon dioxide levels [Spearman's rank correlation test ( rs) = 0.64, P = 0.008 and rs = 0.50, P = 0.05, respectively]. Ethane also correlated with heart rate ( rs = 0.52, P < 0.05). There was an inverse correlation between transcutaneous pulse oximetry and exhaled carbon monoxide ( rs = -0.64, P = 0.008). Significant differences were identified between men ( n = 8) and women ( n = 8) in the concentrations of carbon monoxide (4 parts per million in men vs. 3 parts per million in women; P = 0.01) and volatile sulfur-containing compounds (134 parts per billion in men vs. 95 parts per billion in women; P = 0.016). There was a peak in ethanol concentration directly after food consumption and a significant decrease in ethanol concentration 2 h later ( P = 0.01; n = 16). Sulfur-containing molecules increased linearly throughout the study period (β = 7.4, P < 0.003). Ventilation patterns strongly influence quantification of volatile analytes in exhaled breath and thus, accordingly, the breathing pattern should be controlled to ensure representative analyses.

scholarly journals Elevated End-Tidal Carbon Monoxide Concentration in Children with Sickle Cell Anemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1390-1390
Author(s):  
Ashutosh Lal ◽  
Kristen Yen ◽  
Lasandra Patterson ◽  
Alisa Goldrich ◽  
Anne M Marsh ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Young Children ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Second Hand Smoke ◽  
Control Group ◽  
Exhaled Breath ◽  
Healthy Children ◽  
The Mean ◽  
End Tidal

Abstract Background: Carbon monoxide (CO) produced during oxygen-dependent cleavage of porphyrin ring of heme is excreted in exhaled breath. The catabolism of heme is increased when red blood cells are destroyed at an accelerated rate. Thus, quantifying CO in exhaled breath could serve as an indicator of hemolysis. However, the requirement for forced breath sample has limited the measurement of exhaled CO in young children. Objective: To assess end-tidal CO concentration (ETCOc) in children with sickle cell anemia (SCA). Design/Methods: ETCOc was measured using the CoSense ETCO Monitor (Capnia Inc. Palo Alto, CA). Children between 5-14 years with SCA (Hb SS) who were not on chronic transfusions were eligible. Healthy children served as age-matched controls. Children with exposure to second-hand smoke, acute respiratory infection or symptomatic asthma were excluded. End-tidal breath samples were collected by placing the tip of a nasal cannula 5 mm into the nares. Up to 3 measurements were taken for each subject and the highest ETCOc value was used for analysis. (ClinicalTrials.gov: NCT01848691) Results: The mean (range) age of 16 children with SCA and 16 controls was 9.7 years (5-14 years) and 9.9 years (5-14 years), respectively. The mean (± s.d.) ETCOc for SCA was 4.85 ± 2.24 ppm versus 0.96 ± 0.54 ppm for control group (p<0.001). The ETCOc in the control group ranged from 0.2 to 2.3 ppm, but was ≤1.2 ppm in 14/16, which is suggested as the upper limit of normal for healthy children. In the SCA group, the ETCOc range was 1.8 to 9.7 ppm, with values ≥2.4 ppm in 15/16 subjects. A threshold ETCOc value of >2.1 ppm provided both sensitivity and specificity equal to 93.8% (69.8-99.8%) for distinguishing SCA from healthy children. Children with SCA who had higher absolute reticulocyte count also demonstrated higher ETCOc (r=0.62, p=0.011). Patients with severe anemia (hemoglobin <8 g/dL) had a higher mean ETCOc (5.43 ppm) than the rest (4.40 ppm) but the difference was not significant. ETCOc level tended to increase with age in SCA (r=0.45, p=0.08). Conclusions: Carbon monoxide in exhaled breath can be measured in young children in the clinic using a portable monitor. ETCOc may be a valuable tool for non-invasive monitoring of the severity of hemolysis in SCA. The mean ETCOc was 5-fold higher in SCA compared with controls, with little overlap seen between the groups. This suggests a potential use for ETCOc as a point-of-care screening test for SCA in children. Figure 1 Figure 1. Figure 2 Figure 2. Disclosures Lal: Capnia, Inc: Research Funding. Yen:Capnia, Inc. : Employment. Bhatnagar:Capnia, Inc: Employment.

scholarly journals Elevated Carbon Monoxide to Carbon Dioxide Ratio in the Exhaled Breath of Mice Treated With a Single Dose of Lipopolysaccharide

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Arash Ghalyanchi Langeroudi ◽  
Charlotte M. Hirsch ◽  
Azadeh Shojaee Estabragh ◽  
Simone Meinardi ◽  
Donald R. Blake ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Carbon Monoxide ◽  
Resistant Mutant ◽  
Heme Oxygenase 1 ◽  
Exhaled Breath ◽  
Adult Mice ◽  
Endogenous Production ◽  
Experimental Mouse ◽  
Carbon Dioxide Co2 ◽  
Different Doses

Background.  Analysis of volatile organic chemicals in breath holds promise for noninvasive diagnosis and monitoring of patients, but investigation of this in experimental mouse models has been limited. Of particular interest is endogenous production of carbon monoxide as a biomarker of inflammation and, more particularly, during sepsis. Methods.  Using a nose-only collection procedure for unanesthetized individual adult mice and sensitive gas chromatography of carbon monoxide (CO) and carbon dioxide (CO2) of sampled breath, we investigated the responses of mice to one-time injections with different doses of purified Escherichia coli lipopolysaccharide. Two strains of mice were examined: BALB/c and C3H, including an endotoxin-resistant mutant (HeJ) as well as the wild type (HOuJ). Results.  The CO to CO2 ratio increased in a dose-responsive manner within hours in treated BALC/c mice but not control mice. The CO/CO2 values declined to the range of control mice within 48–72 h after the injection of lipopolysaccharide. Breath CO/CO2 values correlated with systemic inflammation biomarkers in serum and heme oxygenase-1 gene expression in blood. C3H/HOuJ mice, but not the HeJ mice, had similar increases of the CO/CO2 ratio in response to the endotoxin. Conclusions.  Carbon monoxide concentrations in exhaled breath of at least 2 strains of mice increase in response to single injections of endotoxin. The magnitude of increase was similar to what was observed with a bacteremia model. These findings with an experimental model provide a rationale for further studies of normalized CO concentrations in human breath as an informative biomarker for staging and monitoring of sepsis.

scholarly journals Decreased Pulmonary Function Measured in Children Exposed to High Environmental Relative Moldiness Index Homes

2013 ◽  
Vol 7 (1) ◽  
pp. 83-86 ◽  
Author(s):  
Stephen J. Vesper ◽  
Larry Wymer ◽  
Suzanne Kennedy ◽  
L. Faye Grimsley
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Respiratory Health ◽  
Rank Correlation ◽  
Inverse Correlation ◽  
Dust Sample ◽  
Forced Expiratory Volume ◽  
Spearman’S Rank Correlation ◽  
Water Damage ◽  
The Impact

Background: Exposures to water-damaged homes/buildings has been linked to deficits in respiratory health. However, accurately quantifying this linkage has been difficult because of the methods used to assess water damage and respiratory health. Purpose: The goal of this analysis was to determine the correlation between the water-damage, as defined by the Environmental Relative Moldiness Index (ERMI) value in an asthmatic child’s home, and the child’s pulmonary function measured by spirometry, “forced expiratory volume in one second, percent predicted” or FEV1%. Methods: This analysis utilized data obtained from the “Heads-off Environmental Asthma in Louisiana” (HEAL) study. The children (n= 109), 6 to 12 years of age, who had completed at least one spirometry evaluation and a dust sample collected for ERMI analysis from the home at approximately the same time as the spirometry testing, were included in the analysis. Statistical evaluation of the correlation between ERMI values and FEV1% was performed using the Spearman’s Rank Correlation analysis. The relationship between ERMI values and FEV1% was performed using B-spline regression. Results: The average ERMI value in the HEAL study homes was 7.3. For homes with ERMI values between 2.5 and 15, there was a significant inverse correlation with the child’s lung function or FEV1% measurement (Spearman’s rho -0.23; p= 0.03), i.e. as the ERMI value increased, the FEV1% value decreased. Conclusions: Measures of water-damage (the ERMI) and clinical assessments of lung function (FEV1%) provided a quantitative assessment of the impact of water-damaged home exposures on children’s respiratory health.

Carbon Monoxide and Nonquantitative Carbon Dioxide Detection

1996 ◽  
Vol 11 (4) ◽  
pp. 276-279 ◽  
Author(s):  
Georg Petroianu ◽  
Wolfgang Maleck ◽  
Wolfgang Bergler ◽  
Roderich Ruefer
Keyword(s):  
Carbon Dioxide ◽  
Carbon Monoxide ◽  
Endotracheal Tube ◽  
Reliable Method ◽  
Hospital Setting ◽  
Infrared Spectrometry ◽  
End Tidal Carbon Dioxide ◽  
Tube Position ◽  
Carbon Dioxide Detection ◽  
End Tidal

AbstractIntroduction:The capnometric demonstration of end-tidal carbon dioxide (CO2) is a reliable method of differentiating between a correct endotracheal tube position and an accidental misplacement of the tube into the esophagus. Recently, several CO2 detectors have been introduced for monitoring end-tidal CO2 in the “out-of-hospital” setting, where quantitative capnometry with capnography is not yet available.Hypothesis:These devices are not influenced by carbon monoxide (CO) present in lethal concentration.Methods:A heated (37°C) 2.3 L reservoir bag filled one-third full with water (representing the stomach in esophageal misintubation) was machine ventilated (tidal volume: 450 ml; frequency: 16/min) with the following mixtures for three minutes each: 1) 95% O2, 5% CO; 2) 45% O2 5% CO, 50% N2O; and 3) 44% O2 5% CO, 50% N2O, 1% halothane. The presence of end-tidal CO2 was monitored with each of the following devices: 1) MiniCAP™ III CO2 Detector; 2) StatCAP™ CO2 Detector; 3) EasyCAP™ CO2 Detector; PediCAP™ CO2 Detector; and 5) Colibri™ CO2 Detector.Results:In none of the cases was the presence of CO2 signaled by the detector.Conclusion:The presence of 5% CO does not interfere with infrared spectrometry detection (MiniCAP™ and StatCAP™) or chemical detection (EasyCAP™, PediCAP™, and Colibri™) of CO2. The devices can be used safely in patients with CO poisoning for monitoring of endotracheal tube position.

scholarly journals Assessment of trait and state anxiety in 3-6-year old children during sequential phases of dental treatment

2020 ◽  
Vol 1 (1) ◽  
pp. 22-32
Author(s):  
Priya Subramaniam ◽  
◽  
Maryam Haqh ◽  
Megha Gupta ◽  
◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
State Anxiety ◽  
Rating Scale ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Rank Correlation ◽  
Inverse Correlation ◽  
Behavior Rating Scale ◽  
Spearman’S Rank Correlation ◽  
Trait And State Anxiety

Aim: To assess changes in trait and state anxiety of children during sequential phases of dental treatment. Methods: Three hundred children, aged between 3 to < 6 years, who reported for their first dental visit were included. Both parents and children were evaluated over five sequential phases of dental treatment. Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS) and Modified Dental Anxiety Scale (MDAS) were used to assess child’s trait anxiety. Children’s Emotional Manifestation Scale (CEMS) and Facial Image Scale (FIS) were used to assess child’s state anxiety. Child’s behavior was rated using Frankl’s Behavior Rating Scale (FBRS). Paired sample t-test, Pearson’s Correlation coefficient and Spearman’s Rank Correlation coefficient was performed. Results: Mean CFSS-DS and CEMS scores decreased significantly from the first (26.55; 10.25) to the fifth visit (24.74; 8.1) (p<0.05). A significant decrease in the mean FIS (state anxiety) score from the first (2.70) to fifth (2.48) visit was seen (p<0.05) Children’s behavior differed significantly between the dental visits.(p<0.001) There was a significant inverse correlation between behavior and both trait and state anxiety (p<0.05). Conclusions: Sequential phases of dental treatment significantly reduced trait and state anxiety.

A Study of the Relationships between Nursing Students’ Meanings of Life, Positive Beliefs, and Well-Being

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Fu-Ju Tsai ◽  
Cheng-Yu Chen ◽  
Gwo-Liang Yeh ◽  
Yih-Jin Hu ◽  
Chie-Chien Tseng ◽  
...  
Keyword(s):  
Health Promotion ◽  
Nursing Students ◽  
Analysis Of Variance ◽  
Rank Correlation ◽  
Meaning Of Life ◽  
Well Being ◽  
Social Health ◽  
Cross Sectional ◽  
Nursing Educators ◽  
Spearman’S Rank Correlation

Background: Nursing educators should train nursing students to pursue physical, psychological, spiritual, and social health promotion. The purpose of this study was to explore relationships between nursing students’ meaning of life, positive beliefs, and well-being. Methods: A cross-sectional correlational study with a quantitative approach was adopted. Purposive sampling was used. A total of 170 nursing students voluntarily participated in this study. A 56-item questionnaire was used to examine nursing students’ meaning of life (1-25 items), positive beliefs (1-11 items), and well-being (1-20 items). The content validity index (CVI) of the study questionnaire was established as 0.95 by seven expert scholars. The reliability values for the three parts of the measure were as follows: meaning of life, Cronbach’s α 0.96; positive beliefs, Cronbach’s α 0.93; and well-being, Cronbach’s α 0.95. Percentages, frequencies, means, SDs, Kruskal-Wallis one-way analysis of variance by rank, Spearman’s rank correlation, one-way analysis of variance, Spearman’s rho correlation, and regression analysis were used for the data analysis. Results: Nursing students had the following mean scores: meaning of life with 4.02 (SD 0.56); positive beliefs with 3.92 (SD 0.62); and well-being with 3.95 (SD 0.57). The results indicate that for all nursing students, meaning of life was positively correlated with positive beliefs, r=0.83 (P<.01); similarly, all nursing students had positive beliefs that were positively correlated with meaning of life, r=0.83 (P<.01). In the results of the study, the nursing students’ background, meaning of life and positive beliefs explained 63% of the variance in well-being (Adjusted R2 squared =0.63, F=33.41, P<.001). Conclusions: Nursing students’ sense of meaning of life and positive beliefs may impact their well-being. Therefore, nursing educators can promote meaning of life and positive beliefs to nursing students as a way to increase their well-being for physical, psychological, spiritual, and social health promotion.

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