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Published ahead of print on September 4, 2003, doi:10.1164/rccm.200302-248OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 10, November 2003, 1227-1231

A more recent version of this article appeared on November 15, 2003
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Submitted on February 24, 2003
Accepted on August 30, 2003

End tidal carbon monoxide corrected for lung volume is elevated in cystic fibrosis patients

Suzanne W Terheggen-Lagro1*, Marielle W Bink1, Hendrik J Vreman2, and Cornelis K van der Ent1

1 Pediatric Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands, 2 Pediatrics, Stanford University Medical Center, Stanford, CA, USA

* To whom correspondence should be addressed. E-mail: s.terheggen{at}wkz.azu.nl.

Several factors influence levels of end tidal CO (ETCO). We studied determinants of ETCO corrected for inhaled CO (ETCOc) levels in healthy controls and compared ETCOc levels and determinants between healthy controls and cystic fibrosis (CF) patients. Thirty healthy controls, mean ± SD age 23 ±6 years, and twenty clinically stable CF patients, aged 13.5 ± 3.5 years were included. ETCO was measured with the CO-STAT® End Tidal Breath Analyzer and determinants included lung volume (measured with the multiple-breath helium wash-in method), CO-diffusion capacity and different expiratory flow rates. In healthy controls we found a significant correlation between ETCOc and lung volume (r=0.64, p<0.05)and with CO diffusion capacity uncorrected for alveolar volume (r=0.48, p=0.02). There was no expiratory flow rate dependency in either group. CF patients showed no difference in ETCOc levels compared to controls (mean 1.2 ± 0.4 ppm versus 1.3 ± 0.4 ppm, p=0.32) but CF patients had lower TCL-He than healthy controls. ETCOc corrected for lung volume was significantly higher in CF patients compared to controls (p<0.001). We hypothesize that a possible increase in breath CO caused by airway inflammation might be masked by differences in lung volumes between controls and CF patients.
Key words: ETCOc, inflammatory marker, lung volume, cystic fibrosis




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