Diagnostic Value of Exhaled Carbon Monoxide as an Early Marker of Exacerbation in Children with Chronic Lung Diseases

Khalek, Karima A. Abd El; Seify, Magda Y. El; Youssef, Omneya Ibrahim; Badr, Mona M.

doi:10.5402/2012/859873

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…[39][40][41] Also ECO could serve as an indicator of acute exacerbations in children with CLD. [42] It is likely that ECO derives from an endogenous source since the inhaled HO inhibitor, tinmesoporphyrin, significantly inhibits the concentration of CO. [43] ECO measurement is simple, reproducible and non-invasive. Therefore, measuring the level of ECO in COPD cases along with spirometry forms a new approach for better understanding of pathophysiology of COPD cases, with indirect assessment of airway inflammation, oxidative stress and severity of airway obstruction.…”

Section: Discussionmentioning

confidence: 99%

Utility of measuring Exhaled Carbon Monoxide (ECO) level in addition to Pulmonary Function Test (Spirometry) in the monitoring of Chronic Obstructive Pulmonary Disease (COPD)

Yuvarajan¹

2014

Int J Med Sci Public Health

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Background: The measurement of ECO may represent a new method for the non-invasive monitoring of airway inflammation and oxidant stress in Chronic Obstructive Pulmonary Disease, asthma, bronchiectasis, cystic fibrosis patients. Quantification of lung oxidative stress in stable COPD patients by measuring ECO levels may also contribute to the understanding of the pathophysiology of COPD. Aims & Objective:To study the utility of measuring Exhaled Carbon Monoxide (ECO) level in addition to Pulmonary Function Test (Spirometry) in the monitoring of Chronic Obstructive Pulmonary Disease (COPD). Materials and Methods: COPD patients who were smokers and with a history of exposure to wood smoke (n =60) and healthy nonsmokers as control (n =40) were selected as subjects by fulfilling the exclusion criteria as per the GOLD guidelines. Clinical examinations and spirometry including reversibility test were made following the standard protocol/procedure. ECO was measured using a MICRO III Smokerlyser. Results: The difference in level of ECO between COPD cases and healthy non-smokers was highly significant (F = 23.897; df = 98; p < 0.0001). The difference in the level of ECO among different groups (mild, moderate, severe and very severe) was highly significant (F=15.995; df =2; p<0.0001). ECO level in female COPD cases who were exposed to wood smoke was elevated (4.11 ± 1.323) when compared to healthy female non-smokers (1.50 ± 0.519) and the difference was highly significant. (F =1.593; df = 30; p < 0.0001). Conclusion: ECO levels in COPD cases vary with different grades of air way obstruction. We concluded that measuring the level of ECO in COPD cases along with spirometry forms a new approach for better understanding of pathophysiology of COPD cases, with indirect assessment of airway inflammation, oxidative stress and severity of airway obstruction.

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Section: Discussionmentioning

confidence: 99%

Utility of measuring Exhaled Carbon Monoxide (ECO) level in addition to Pulmonary Function Test (Spirometry) in the monitoring of Chronic Obstructive Pulmonary Disease (COPD)

Yuvarajan¹

2014

Int J Med Sci Public Health

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“…eCO can be measured noninvasively with an electrochemical sensor in an easy-to-use portable device. 314 To measure eCO, subjects take in a deep inhalation, hold their breath for 15–20 s, and then exhale into the unit. 307,311,315,316 The breath-hold allows for the amount of CO expired to be in equilibrium with the concentration of carboxyhemoglobin in the blood.…”

Section: Respiratory End Pointsmentioning

confidence: 99%

Noninvasive effects measurements for air pollution human studies: methods, analysis, and implications

Mirowsky

Gordon

2015

J Expo Sci Environ Epidemiol

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Human exposure studies, compared with cell and animal models, are heavily relied upon to study the associations between health effects in humans and air pollutant inhalation. Human studies vary in exposure methodology, with some work conducted in controlled settings, whereas other studies are conducted in ambient environments. Human studies can also vary in the health metrics explored, as there exists a myriad of health effect end points commonly measured. In this review, we compiled mini reviews of the most commonly used noninvasive health effect end points that are suitable for panel studies of air pollution, broken into cardiovascular end points, respiratory end points, and biomarkers of effect from biological specimens. Pertinent information regarding each health end point and the suggested methods for mobile collection in the field are assessed. In addition, the clinical implications for each health end point are summarized, along with the factors identified that can modify each measurement. Finally, the important research findings regarding each health end point and air pollutant exposures were reviewed. It appeared that most of the adverse health effects end points explored were found to positively correlate with pollutant levels, although differences in study design, pollutants measured, and study population were found to influence the magnitude of these effects. Thus, this review is intended to act as a guide for researchers interested in conducting human exposure studies of air pollutants while in the field, although there can be a wider application for using these end points in many epidemiological study designs.

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“…In the Copenhagen Heart Study, eCO values among smokers had no correlation to lung function or lung function decline [90]. Recent studies conclude that eCO levels may also correlate with exacerbations in chronic lung disease in children [103]. eCO values were also measured in α-1 anti-trypsin (α1-AT) deficiency, a genetic cause of emphysema associated with increased neutrophil elastase activity and lung tissue destruction which arises independently of smoking status.…”

Section: Carbon Monoxide In Exhaled Breathmentioning

confidence: 99%

Carbon monoxide in exhaled breath testing and therapeutics

2013

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Carbon monoxide (CO), a low molecular weight gas, is a ubiquitous environmental product of organic combustion, which is also produced endogenously in the body, as the byproduct of heme metabolism. CO binds to hemoglobin, resulting in decreased oxygen delivery to bodily tissues at toxicological concentrations. At physiological concentrations, CO may have endogenous roles as a potential signaling mediator in vascular function and cellular homeostasis. Exhaled CO (eCO), similar to exhaled nitric oxide (eNO), has been evaluated as a candidate breath biomarker of pathophysiological states, including smoking status, and inflammatory diseases of the lung and other organs. eCO values have been evaluated as potential indicators of inflammation in asthma, stable COPD and exacerbations, cystic fibrosis, lung cancer, or during surgery or critical care. The utility of eCO as a marker of inflammation, and potential diagnostic value remains incompletely characterized. Among other candidate “medicinal gases” with therapeutic potential, (e.g., NO and H2S), CO has been shown to act as an effective anti-inflammatory agent in preclinical animal models of inflammatory disease, acute lung injury, sepsis, ischemia/reperfusion injury and organ graft rejection. Current and future clinical trials will evaluate the clinical applicability of this gas as a biomarker and/or therapeutic in human disease.

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Diagnostic Value of Exhaled Carbon Monoxide as an Early Marker of Exacerbation in Children with Chronic Lung Diseases

Cited by 7 publications

References 18 publications

Utility of measuring Exhaled Carbon Monoxide (ECO) level in addition to Pulmonary Function Test (Spirometry) in the monitoring of Chronic Obstructive Pulmonary Disease (COPD)

Utility of measuring Exhaled Carbon Monoxide (ECO) level in addition to Pulmonary Function Test (Spirometry) in the monitoring of Chronic Obstructive Pulmonary Disease (COPD)

Noninvasive effects measurements for air pollution human studies: methods, analysis, and implications

Carbon monoxide in exhaled breath testing and therapeutics

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