The Impact of Breathing Pattern and Lung Size on the Alcohol Breath Test

Hlastala, Michael P.; Anderson, Joseph C.

doi:10.1007/s10439-006-9216-3

Cited by 33 publications

(33 citation statements)

References 12 publications

(23 reference statements)

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“…Heavy alcohol consumption, or abuse, increases morbidity among patients with community-acquired pneumonia. Others have suggested that both the delivery of ethanol to airways in the lungs during chronic alcohol abuse, and formation and accumulation of metabolites of ethanol may contribute to other lung and airway disorders, including asthma (Hlastala., 1998; Hlastala and Anderson, 2007; Siu et al , 2010; Kaphalia and Calhoun, 2013). Accordingly, the metabolic and immunologic effects of moderate consumption of alcohol are of considerable interest, both scientifically and clinically.…”

Section: Introductionmentioning

confidence: 99%

Ethanol metabolism, oxidative stress, and endoplasmic reticulum stress responses in the lungs of hepatic alcohol dehydrogenase deficient deer mice after chronic ethanol feeding

Kaphalia

Boroumand

et al. 2014

Toxicology and Applied Pharmacology

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Consumption and over-consumption of alcoholic beverages are well-recognized contributors to a variety of pulmonary disorders, even in the absence of intoxication. The mechanisms by which alcohol (ethanol) may produce disease include oxidative stress and prolonged endoplasmic reticulum (ER) stress. Many aspects of these processes remain incompletely understood due to a lack of a suitable animal model. Chronic alcohol over-consumption reduces hepatic alcohol dehydrogenase (ADH), the principal canonical metabolic pathway of ethanol oxidation. We therefore modeled this situation using hepatic ADH-deficient deer mice fed 3.5% ethanol daily for 3 months. Blood ethanol concentration was 180 mg% in ethanol fed mice, compared to <0.2% in the controls. Acetaldehyde (oxidative metabolite of ethanol) was minimally, but significantly increased in ethanol-fed vs. pair-fed control mice. Total fatty acid ethyl esters (FAEEs, nonoxidative metabolites of ethanol) were 47.6 μg/g in the lungs of ethanol-fed mice as compared to 1.5 μg/g in pair-fed controls. Histological and immunohistological evaluation showed perivascular and peribronchiolar lymphocytic infiltration, and significant oxidative injury, in the lungs of ethanol-fed mice compared to pair-fed controls. Several fold increases for cytochrome P450 2E1, caspase 8 and caspase 3 found in the lungs of ethanol-fed mice as compared to pair-fed controls suggest role of oxidative stress in ethanol-induced lung injury. ER stress and unfolded protein response signaling were also significantly increased in the lungs of ethanol-fed mice. Surprisingly, no significant activation of inositol-requiring enzyme-1α and spliced XBP1 were observed indicating a lack of activation of corrective mechanisms to reinstate ER homeostasis. The data suggest that oxidative stress and prolonged ER stress, coupled with formation and accumulation of cytotoxic FAEEs may contribute to the pathogenesis of alcoholic lung disease.

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Section: Introductionmentioning

confidence: 99%

Ethanol metabolism, oxidative stress, and endoplasmic reticulum stress responses in the lungs of hepatic alcohol dehydrogenase deficient deer mice after chronic ethanol feeding

Kaphalia

Boroumand

et al. 2014

Toxicology and Applied Pharmacology

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“…From our recent investigations, gases that are highly soluble in both blood and water (λ w =λ b >100 like acetone) exchange primarily in the airways (Fig 2A). The mechanism of this exchange has been described for elimination of soluble gases from the body 1,3,4,18,23 . Fresh inhaled air absorbs inert gas from the airway mucus, depletes the concentration of soluble gas in the mucous layer, and becomes fully saturated with highly soluble gas before reaching the alveoli.…”

Section: Discussionmentioning

confidence: 99%

Impact of Airway Gas Exchange on the Multiple Inert Gas Elimination Technique: Theory

Anderson

Hlastala

2010

Ann Biomed Eng

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The multiple inert gas elimination technique (MIGET) provides a method for estimating alveolar gas exchange efficiency. Six soluble inert gases are infused into a peripheral vein. Measurements of these gases in breath, arterial blood, and venous blood are interpreted using a mathematical model of alveolar gas exchange (MIGET model) that neglects airway gas exchange. A mathematical model describing airway and alveolar gas exchange predicts that two of these gases, ether and acetone, exchange primarily within the airways. To determine the effect of airway gas exchange on the MIGET, we selected two additional gases, toluene and m-dichlorobenzene, that have the same blood solubility as ether and acetone and minimize airway gas exchange via their low water solubility. The airway-alveolar gas exchange model simulated the exchange of toluene, m-dichlorobenzene, and the six MIGET gases under multiple conditions of alveolar ventilation-to-perfusion, V̇A/Q̇, heterogeneity. We increased the importance of airway gas exchange by changing bronchial blood flow, Q̇br. From these simulations, we calculated the excretion and retention of the eight inert gases and divided the results into two groups: 1) the standard MIGET gases which included acetone and ether and 2) the modified MIGET gases which included toluene and m-dichlorobenzene. The MIGET mathematical model predicted distributions of ventilation and perfusion for each grouping of gases and multiple perturbations of V̇A/Q̇ and Q̇br. Using the modified MIGET gases, MIGET predicted a smaller dead space fraction, greater mean V̇A, greater log(SDVA), and more closely matched the imposed V̇A distribution than that using the standard MIGET gases. Perfusion distributions were relatively unaffected.

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“…This may lead to bias against people with smaller lung size. 9 We postulated that patients with significant chest injuries would not be able activate the breath analysis device due to pain and compromised respiratory function. In testing this hypothesis on patients undergoing thoracic surgical procedures, we chose the 2 nd postoperative day because they were on patient-controlled morphine analgesia rather than epidural or intrathecal morphine, which are not comparable to the morphine analgesia provided by pre-hospital care practitioners or accident and emergency departments.…”

Section: Discussionmentioning

confidence: 99%

Can Chest Trauma Patients Provide Breath Sample with Lion SD-400 Alcometer?

Rathinam

Luke

Nanjaiah

et al. 2009

Asian Cardiovasc Thorac Ann

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Various investigators have addressed the minimum lung function required to activate breathalyzers, and the impact of comorbid respiratory illness. We postulated that subjects with significant chest trauma may have difficulty in providing an adequate breathalyzer sample. A prospective self-controlled study of 20 patients who underwent thoracotomy was conducted between August 2005 and December 2005, using a Lion Alcometer SD-400. The mean age of the patients was 69.3 years (range, 37-83 years). Preoperatively, their mean forced expiratory volume was 1.97 L (range, 1.19-2.46 L), and peak expiratory flow rate was 240 L min(-1) (range, 126-520 L min(-1)). Postoperatively, mean forced expiratory volume was 1.14 L (range, 0.34-2.2 L) and peak expiratory flow rate was 179 L min(-1) (range, 36-492 L min(-1)). These decreases were highly significant. All patients activated the breathalyzer device preoperatively, but only 2 (10%) could activate it postoperatively. Extrapolating this to patients with chest injury, most may find it impossible to activate breathalyzers.

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The Impact of Breathing Pattern and Lung Size on the Alcohol Breath Test

Cited by 33 publications

References 12 publications

Ethanol metabolism, oxidative stress, and endoplasmic reticulum stress responses in the lungs of hepatic alcohol dehydrogenase deficient deer mice after chronic ethanol feeding

Ethanol metabolism, oxidative stress, and endoplasmic reticulum stress responses in the lungs of hepatic alcohol dehydrogenase deficient deer mice after chronic ethanol feeding

Impact of Airway Gas Exchange on the Multiple Inert Gas Elimination Technique: Theory

Can Chest Trauma Patients Provide Breath Sample with Lion SD-400 Alcometer?

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