| 1. |
- Lindberg, Lars, et al.
(author)
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Simultaneously recorded single-exhalation profiles of ethanol, water vapour and CO2 in humans: impact of pharmacokinetic phases on ethanol airway exchange
- 2012
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In: Journal of Breath Research. - : IOP Publishing. - 1752-7163 .- 1752-7155. ; 6:3
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Journal article (peer-reviewed)abstract
- The breath alcohol concentration (BrAC) standardized to the alveolar water vapour concentration has been shown to closely predict the arterial blood alcohol (ethanol) concentration (ABAC). However, a transient increase in the ABAC/BrAC ratio has been noted, when alcohol is absorbed from the gastrointestinal tract (absorption phase) and the ABAC rapidly rises. We analysed the plot of simultaneously recorded alcohol, water vapour and CO2 against exhaled volume (volumetric expirogram) for respiratory dead space volume (VD), cumulative gas output and phase III slope within one breath to evaluate whether changes in the BrAC profile could explain this variability. Eight healthy subjects performed exhalations through pre-heated non-restrictive mouthpieces and the concentrations were measured by infrared absorption. In the absorption phase, the respiratory VD of alcohol was transiently increased and the exhaled alcohol was displaced to the latter part of the expirogram. In the post-absorption phase, the respiratory VD for alcohol and water vapour was stable and always less than the respiratory VD for CO2, indicating that the first part of the exhaled alcohol and water originated from the conducting airway. The position of the BrAC profile between water vapour and CO2 in the post-absorptive phase indicates an interaction within the conducting airway, probably including a deposition of alcohol onto the mucosa during exhalation. We conclude that the increase in the ABAC/BrAC ratio during the absorption phase of alcohol coincides with a transient increase in respiratory VD of alcohol and a delay in the appearance of alcohol in the exhaled air as the exhalation proceeds compared with the post-absorption phase.
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| 2. |
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| 3. |
- Cristescu, S. M., et al.
(author)
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Methods of NO detection in exhaled breath
- 2013
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In: Journal of Breath Research. - : IOP Publishing. - 1752-7155 .- 1752-7163. ; 7:1, s. 017104-
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Journal article (peer-reviewed)abstract
- There is still an unexplored potential for exhaled nitric oxide (NO) in many clinical applications. This study presents an overview of the currently available methods for monitoring NO in exhaled breath and the use of the modelling of NO production and transport in the lung in clinical practice. Three technologies are described, namely chemiluminescence, electrochemical sensing and laser-based detection with their advantages and limitations. Comparisons are made in terms of sensitivity, time response, size, costs and suitability for clinical purposes. The importance of the flow rate for NO sampling is discussed from the perspective of the recent recommendations for standardized procedures for online and offline NO measurement. The measurement of NO at one flow rate, such as 50 ml s(-1), can neither determine the alveolar site/peripheral contribution nor quantify the difference in NO diffusion from the airways walls. The use of NO modelling (linear or non-linear approach) can solve this problem and provide useful information about the source of NO. This is of great value in diagnostic procedures of respiratory diseases and in treatment with anti-inflammatory drugs.
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| 4. |
- Högman, Marieann, et al.
(author)
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A practical approach to the theoretical models to calculate NO parameters of the respiratory system
- 2014
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In: Journal of breath research. - : IOP Publishing. - 1752-7163 .- 1752-7155. ; 8:1, s. 016002-
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Journal article (peer-reviewed)abstract
- Expired nitric oxide (NO) is used as a biomarker in different respiratory diseases. The recommended flow rate of 50 mL s⁻¹ (F(E)NO₀.₀₅) does not reveal from where in the lung NO production originated. Theoretical models of NO transfer from the respiratory system, linear or nonlinear approaches, have therefore been developed and applied. These models can estimate NO from distal lung (alveolar NO) and airways (bronchial flux). The aim of this study was to show the limitation in exhaled flow rate for the theoretical models of NO production in the respiratory system, linear and nonlinear models. Subjects (n = 32) exhaled at eight different flow rates between 10-350 mL s⁻¹ for the theoretical protocols. Additional subjects (n = 32) exhaled at tree flow rates (20, 100 and 350 mL s⁻¹) for the clinical protocol. When alveolar NO is calculated using high flow rates with the linear model, correction for axial back diffusion becomes negligible, -0.04 ppb and bronchial flux enhanced by 1.27. With Högman and Meriläinen algorithm (nonlinear model) the corrections factors can be understood to be embedded, and the flow rates to be used are ≤20, 100 and ≥350 mL s⁻¹. Applying these flow rates in a clinical setting any F(E)NO can be calculated necessitating fewer exhalations. Hence, measured F(E)NO₀.₀₅ 12.9 (7.2-18.7) ppb and calculated 12.9 (6.8-18.7) ppb. In conclusion, the only possibility to avoid inconsistencies between research groups is to use the measured NO values as such in modelling, and apply tight quality control to accuracies in both NO concentration and exhaled flow measurements.
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| 5. |
- Högman, Marieann
(author)
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Extended NO analysis in health and disease
- 2012
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In: Journal of breath research. - : IOP Publishing. - 1752-7163 .- 1752-7155. ; 6:4, s. 047103-
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Journal article (peer-reviewed)abstract
- Extended NO analysis is a promising tool in different diseases where NO metabolism is altered. One single exhalation cannot give insight to the NO production in the respiratory system; rather the use of multiple exhalation flows can give the alveolar levels (CANO), airway wall concentration (CawNO) and the diffusion rate of NO (DawNO). Increased values of CANO are shown in COPD, systemic sclerosis, hepatopulmonary syndrome and in severe asthma. In asthma the CawNO and DawNO are increased leading to an increase in bronchial NO flux (J'awNO). Low levels of J'awNO are seen in cystic fibrosis, primary ciliary dyskinesia and in smoking subjects. More studies are needed to evaluate the clinical usefulness of the extended NO analysis, similar to what has been done in systemic sclerosis where a cut-off value has been identified predicting pulmonary function deterioration.
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| 6. |
- Krantz, Christina, et al.
(author)
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Nasal nitric oxide is associated with exhaled NO, bronchial responsiveness and poor asthma control
- 2014
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In: Journal of Breath Research. - : IOP Publishing. - 1752-7155 .- 1752-7163. ; 8:2, s. 026002-
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Journal article (peer-reviewed)abstract
- The fraction of exhaled nitric oxide (FeNO) is an established marker of airway inflammation in asthma. Nasal nitric oxide (nNO) has initially been regarded as a promising marker of inflammation of nasal mucosa. However, due to its dual origins, paranasal sinuses and nasal mucosa, the clinical use of nNO is controversial. There is an inflammatory link between inflammation in the upper and lower airways within the united airways' paradigm, but the study of the clinical value of nNO in asthma has been limited. The objective of this study is to analyse nNO in asthmatics and its relationship to FeNO, bronchial hyperresponsiveness, allergic sensitization and asthma control. A total of 371 children and young adults from an asthma cohort were included in this study, which performed measurements of nNO (through aspiration at 5 mL s(-1)), FeNO, bronchial responsiveness to methacholine, blood eosinophil count (B-Eos) and IgE sensitization. The asthma control test (ACT) and a questionnaire regarding medical treatment, symptoms of asthma, rhinitis and chronic rhinosinusitis were completed by all subjects. An association was found between higher nNO levels and increased bronchial responsiveness (p < 0.001), FeNO (p < 0.001) and B-Eos (p = 0.002). Sensitization to furry animals related to higher levels of nNO (p < 0.001). Subjects with poorly controlled asthma (ACT < 15) had lower levels of nNO than subjects with a higher ACT score (619 +/- 278 ppb, versus 807 +/- 274 ppb, p = 0.002). Loss of smell showed the strongest association with lower nNO levels among the upper airway symptoms recorded. In patients with asthma, nNO was positively correlated with exhaled NO, bronchial responsiveness and asthma control. This study suggests clinical utility of nNO in subjects with asthma, but in order to get better understanding of the nNO determinants, simultaneous mapping of upper airway comorbidities by clinical examination is appropriate.
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| 7. |
- Metsälä, Markus, et al.
(author)
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Acetylene in breath : background levels and real-time elimination kinetics after smoking
- 2010
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In: Journal of Breath Research. - Bristol, UK : Institute of Physics Publishing (IOPP). - 1752-7155 .- 1752-7163. ; 4:4
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Journal article (peer-reviewed)abstract
- We have measured the acetylene concentration in the exhaled breath of 40 volunteers (31 non-smokers, nine smokers) using near-infrared cavity ring-down spectroscopy. The acetylene levels were found to be the same as in ambient air for non-smokers, whereas elevated levels were observed for smokers. Real-time measurements with sub-second time resolution have been applied to measure the elimination kinetics of acetylene in breath after exposure to tobacco smoke. Three exponential time constants can be distinguished from the data and these can be used to define the residence times for different compartments, according to the multi-compartment model of the human body.
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| 8. |
- Schmidt, Florian, et al.
(author)
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Ammonia in breath and emitted from skin
- 2013
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In: Journal of Breath Research. - : IOP Publishing. - 1752-7155 .- 1752-7163. ; 7:1
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Journal article (peer-reviewed)abstract
- Ammonia concentrations in exhaled breath (eNH(3)) and skin gas of 20 healthy subjects were measured on-line with a commercial cavity ring-down spectrometer and compared to saliva pH and plasma ammonium ion (NH4+), urea and creatinine concentrations. Special attention was given to mouth, nose and skin sampling procedures and the accurate quantification of ammonia in humid gas samples. The obtained median concentrations were 688 parts per billion by volume (ppbv) for mouth-eNH(3), 34 ppbv for nose-eNH3, and 21 ppbv for both mouth-and nose-eNH(3) after an acidic mouth wash (MW). The median ammonia emission rate from the lower forearm was 0.3 ng cm(-2) min(-1). Statistically significant (p < 0.05) correlations between the breath, skin and plasma ammonia/ammonium concentrations were not found. However, mouth-eNH(3) strongly (p < 0.001) correlated with saliva pH. This dependence was also observed in detailed measurements of the diurnal variation and the response of eNH(3) to the acidic MW. It is concluded that eNH(3) as such does not reflect plasma but saliva and airway mucus NH4+ concentrations and is affected by saliva and airway mucus pH. After normalization with saliva pH using the Henderson-Hasselbalch equation, mouth-eNH(3) correlated with plasma NH4+, which points to saliva and plasma NH4+ being linked via hydrolysis of salivary urea.
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| 9. |
- Schmidt, Florian M., et al.
(author)
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Background levels and diurnal variations of hydrogen cyanide in breath and emitted from skin
- 2011
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In: Journal of Breath Research. - Bristol, UK : Institute of Physics Publishing (IOPP). - 1752-7163 .- 1752-7155. ; 5:4
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Journal article (peer-reviewed)abstract
- The hydrogen cyanide (HCN) concentration in exhaled human breath and skin gas samples collected with different sampling techniques was measured using near-infrared cavity ring-down spectroscopy. The median baseline HCN concentrations in samples provided by 19 healthy volunteers 2-4 h after the last meal depended on the employed sampling technique: 6.5 parts per billion by volume (ppbv) in mixed (dead space and end-tidal) mouth-exhaled breath collected to a gas sampling bag, 3.9 ppbv in end-tidal mouth-exhaled breath, 1.3 ppbv in end-tidal nose-exhaled breath, 1.0 ppbv in unwashed skin and 0.6 ppbv in washed skin samples. Diurnal measurements showed that elevated HCN levels are to be expected in mouth-exhaled breath samples after food and drink intake, which suggests HCN generation in the oral cavity. The HCN concentrations in end-tidal nose-exhaled breath and skin gas samples were correlated, and it is concluded that these concentrations best reflect systemic HCN levels.
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