End-tidal carbon monoxide measurements in infant respiratory distress syndrome.
BACKGROUND
RDS involving inflammatory and oxidative processes may lead to increased production of carbon monoxide (CO).


OBJECTIVE
The relationship between end-tidal CO, corrected for inhaled CO (ETCOc), and RDS severity was investigated in preterm infants as well as the value of early ETCOc measurements to predict chronic lung disease.


METHODS
78 infants (30 no RDS, 32 moderate RDS, 16 severe RDS) were included. ETCOc was measured using the CO-Stat End Tidal Breath Analyzer.


RESULTS
ETCOc was significantly higher in RDS compared to no RDS during the first week (p<0.05). Severity of RDS was the most significant independent variable in a stepwise regression model related to ETCOc (F-test: 18.17). Negative predictive value of early (within first 12 h of life) ETCOc measurement (<2.5 ppm) for development of chronic lung disease was excellent (100%).


CONCLUSIONS
During severe RDS, inflammation may contribute to increased lipid peroxidation leading to increased local CO production in the lung, indicated by increased ETCOc. Early ETCOc determinations may be helpful to exclude occurrence of chronic lung disease.
Krediet
Tannette G
TG
Department of Neonatology, Wilhemina Children's Hospital, University Medical Center, Utrecht, the Netherlands. t.krediet@wkz.azu.nl
Cirkel
Geert A
GA
Vreman
Hendrik J
HJ
Wong
Ronald J
RJ
Stevenson
David K
DK
Groenendaal
Floris
F
Egberts
Johannes
J
Van Bel
Frank
F
D001944:Breath Tests; D002248:Carbon Monoxide / Q000378:metabolism*; D002908:Chronic Disease; D006801:Humans; D007231:Infant, Newborn; D008171:Lung Diseases / Q000175:diagnosis; D011379:Prognosis; D012127:Respiratory Distress Syndrome, Newborn / Q000378:metabolism*
D002248:Carbon Monoxide