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Published ahead of print on September 25, 2003, doi:10.1164/rccm.200307-920OC
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American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 1500-1505, (2003)
© 2003 American Thoracic Society

A Simple Method for Estimating Respiratory Solute Dilution in Exhaled Breath Condensates

Richard M. Effros, Julie Biller, Bradley Foss, Kelly Hoagland, Marshall B. Dunning, Daniel Castillo, Mark Bosbous, Feng Sun and Reza Shaker

Division of Pulmonary and Critical Care Medicine, Gastroenterology, and Adult Cystic Fibrosis Center, Medical College of Wisconsin, Milwaukee; and Respiratory and Critical Care Division, Zablocki V.A. Hospital, West Allis, Wisconsin

Correspondence and requests for reprints should be addressed to Richard M. Effros, M.D., 30404 Camino Porvenir, Rancho Palos Verdes, CA 90275. E-mail: effros{at}mcw.edu

Exhaled breath condensates have been widely used to detect inflammatory mediators in the fluid that covers airway surfaces of patients with inflammatory lung disorders. This approach is much less invasive than bronchoalveolar lavage, but respiratory droplets are markedly diluted by large and variable amounts of water vapor. We estimated the dilution of respiratory droplets by comparing concentrations of nonvolatile, reference indicators (total nonvolatile cations, urea or conductivity) in 18 normal subjects with normal plasma concentrations by assuming similar concentrations in the respiratory fluid and plasma. The volatile cation, NH4+ (most of which is delivered as NH3 gas from the mouth), represented 93 ± 3% (SEM) of the condensate cations. More than 99% of the NH4+ was removed by lyophilization, making it possible to use conductivity to estimate total nonvolatile ionic concentrations and facilitating analysis of urea. Conductivity was significantly correlated with electrolyte and urea concentrations. Estimates of dilution based on total cations, conductivity, and urea were not significantly different (cations: 20,472 ± 2,516; conductivity: 21,019 ± 2,427; and urea: 18,818 ± 2,402). These observations suggest that the conductivity of lyophilized samples can be used as an inexpensive, simple, and reliable method for estimating dilution of nonvolatile, hydrophilic mediators in condensates.

Key Words: freeze drying • electrical conductivity • cations • urea




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