Increased arteriovenous carboxyhemoglobin differences in patients with inflammatory pulmonary diseases.
OBJECTIVE
Exhaled carbon monoxide and arterial blood carboxyhemoglobin concentrations increase in inflammatory pulmonary diseases. The present study was undertaken to elucidate whether arteriovenous carboxyhemoglobin (a-vHb-CO) concentration differences are also useful to define the site of inflammation, either in the lung or organs other than the lung.


METHODS
We examined concentrations of carboxyhemoglobin in both arterial and peripheral venous blood and exhaled carbon monoxide in patients with acute pulmonary inflammation including bronchial asthma (n = 18) and pneumonia (n = 33), and those in patients with extrapulmonary inflammatory diseases, including acute pyelonephritis (n = 28) and active rheumatoid arthritis (n = 16).


RESULTS
The values of carboxyhemoglobin in both arterial and peripheral venous blood were significantly higher in patients with pulmonary and extrapulmonary inflammation compared with those in control subjects (n = 22). Furthermore, a-vHb-CO differences in patients with inflammatory pulmonary diseases were higher than those in patients with acute pyelonephritis and patients with rheumatoid arthritis, and than those in control subjects. The a-vHb-CO differences correlated with the WBC count of peripheral venous blood in patients with pneumonia. In patients with bronchial asthma, the a-vHb-CO differences inversely correlated with FEV(1), although they did not correlate with WBC count of peripheral venous blood. The a-vHb-CO differences in patients with acute pyelonephritis were higher than those in patients with active rheumatoid arthritis.


CONCLUSIONS
The present study suggests that a-vHb-CO differences may be a useful means to define the site of inflammation, either in the lung or organs other than the lung, in patients with a fever of unknown origin. The large a-vHb-CO differences may be caused by carbon monoxide production in pulmonary inflammation.
Yasuda
Hiroyasu
H
Department of Geriatric and Respiratory Medicine, Tohoku University School of Medicine, Sendai, Japan.
Sasaki
Takahiko
T
Yamaya
Mutsuo
M
Ebihara
Satoru
S
Maruyama
Masahiro
M
Kanda
Akio
A
Sasaki
Hidetada
H
D001158:Arteries / Q000737:chemistry; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis; D001249:Asthma / Q000097:blood / Q000175:diagnosis; D001784:Blood Gas Analysis; D002263:Carboxyhemoglobin / Q000032:analysis / Q000378:metabolism*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators; D008297:Male; D011014:Pneumonia / Q000097:blood* / Q000175:diagnosis*; D011336:Probability; D011379:Prognosis; D011659:Pulmonary Gas Exchange; D011704:Pyelonephritis / Q000097:blood / Q000175:diagnosis; D012016:Reference Values; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014680:Veins / Q000737:chemistry
D018836:Inflammation Mediators; D002263:Carboxyhemoglobin