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Published ahead of print on March 11, 2005, doi:10.1164/rccm.200407-914OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 11, June 2005, 1246-1251

A more recent version of this article appeared on June 1, 2005
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Submitted on July 15, 2004
Accepted on March 4, 2005

Increased Arterial Carboxyhemoglobin Concentrations in Chronic Obstructive Pulmonary Disease

Hiroyasu Yasuda1*, Mutsuo Yamaya1, Katsutoshi Nakayama1, Satoru Ebihara1, Takahiko Sasaki1, Shoji Okinaga1, Daisuke Inoue1, Masanori Asada1, Miyako Nemoto1, and Hidetada Sasaki1

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

* To whom correspondence should be addressed. 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 (a-v) Hb-CO differences, and forced expiratory volume in one second (FEV1) in 58 patients with COPD and 61 ex-smoking control subjects. Results; Arterial Hb-CO in patients at stable conditions were higher than those in control subjects (p< 0.0001). Furthermore, the Hb-CO in patients at the exacerbations (p< 0.0001) were higher than those at the stable conditions. Arterial Hb-CO in patients at stage III were higher than those in patients at stage II, and the Hb-CO 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 COPD patients at stage II and stage III at the exacerbations. Arterial Hb-CO inversely correlated with the arterial blood partial oxygen pressure and FEV1. A-v 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 due to lung and systemic inflammation and production of reactive oxygen species.
Key words: carboxyhemoglobin; heme oxygenase; carbon monoxide; systemic inflammation; chronic obstructive pulmonary disease




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