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Published ahead of print on September 25, 2003, doi:10.1164/rccm.200307-920OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 12, December 2003, 1500-1505

A more recent version of this article appeared on December 15, 2003
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Submitted on July 8, 2003
Accepted on September 22, 2003

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

Richard M Effros1*, Julie Biller2, Bradley Foss1, Kelly Hoagland1, Marshall B Dunning3, Marl Bosbous, Daniel Castillo3, Feng Sun1, and Reza Shaker4

1 Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA; Respiratory and Critical Care Divison, Zablocki VA Hospital, West Allis, WI, USA, 2 Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA; Adult Cystic Fibrosis Center, Medical College of Wisconsin, Milwaukee, WI, USA; Respiratory and Critical Care Divison, Zablocki VA Hospital, West Allis, WI, USA, 3 Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA, 4 Gastroenterology, Medical College of Wisconsin, Milwaukee, WI, USA; Respiratory and Critical Care Divison, Zablocki VA Hospital, West Allis, WI, USA

* To whom correspondence should be addressed. 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 87 ± 12% (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 ± 2516; conductivity: 21,019 ± 2427, and urea: 18,818 ± 2402). 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: Conductivity, lyophilization, airway droplets, exhaled breath condensates, dilution




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