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Published ahead of print on March 11, 2005, doi:10.1164/rccm.200407-914OC
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American Journal of Respiratory and Critical Care Medicine Vol 171. pp. 1246-1251, (2005)
© 2005 American Thoracic Society
doi: 10.1164/rccm.200407-914OC

Original Article

Increased Arterial Carboxyhemoglobin Concentrations in Chronic Obstructive Pulmonary Disease

Hiroyasu Yasuda, Mutsuo Yamaya, Katsutoshi Nakayama, Satoru Ebihara, Takahiko Sasaki, Shoji Okinaga, Daisuke Inoue, Masanori Asada, Miyako Nemoto and Hidetada Sasaki

Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, Sendai, Japan

Correspondence and requests for reprints should be addressed to Hiroyasu Yasuda, M.D., Ph.D., Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. E-mail: yasuda{at}geriat.med.tohoku.ac.jp

Rationale: Exhaled carbon monoxide (CO) and arterial blood carboxyhemoglobin concentrations (Hb-CO) increase in inflammatory pulmonary diseases. Objectives: To study whether arterial Hb-CO is useful to monitor disease activity in patients with chronic obstructive pulmonary disease (COPD) who had stopped smoking. Methods: We measured arterial Hb-CO, arteriovenous Hb-CO differences, and FEV1 in 58 patients with COPD and 61 ex-smoking control subjects. Results: Arterial Hb-CO concentrations in patients at stable conditions were higher than those in control subjects (p < 0.0001). Furthermore, the Hb-CO concentrations in patients at the exacerbations (p < 0.0001) were higher than those at the stable conditions. Arterial Hb-CO concentrations in patients at stage III were higher than those in patients at stage II, and the Hb-CO concentrations in patients at stage IV were higher than those in patients at stage III at the stable conditions and exacerbations. Arterial Hb-CO correlated with exhaled CO in patients with COPD at stage II and stage III at the exacerbations. Arterial Hb-CO inversely correlated with the arterial blood partial oxygen pressure and FEV1. Arteriovenous Hb-CO differences in patients at the exacerbations did not differ from those in patients at stable conditions and from those in control subjects. Moreover, arterial Hb-CO correlated with serum C-reactive protein values and serum lipid peroxide concentrations. Conclusions: These findings suggest that increased arterial Hb-CO may relate to severity in patients with COPD because of lung and systemic inflammation and production of reactive oxygen species.

Key Words: carbon monoxide • carboxyhemoglobin • chronic obstructive pulmonary disease • heme oxygenase • systemic inflammation




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