13CO2 washout kinetics in acute hypercapnia

The oral 13C-bicarbonate technique for determination of energy expenditure in dogs: dietary and environmental factors affecting the respiratory quotient and 13C recovery factor

The oral ¹³C-bicarbonate technique (o¹³CBT) can be used for short-term measurements of CO₂ production (RCO₂) and energy expenditure (EEx). The method relies on appropriate estimates for the respiratory quotient (RQ) and recovery factor (RF) of ¹³C. Four Retriever dogs were included in four experiments to validate the o¹³CBT against indirect calorimetry (IC), and determine RQ and RF; Expt. 1: feeding different protein:fat:carbohydrate ratios [in % of metabolisable energy]: 25:33:42 in a maintenance (Mnt.) diet; 38:26:36 in a high-protein high-fibre (H_Fibre) diet and 27:56:17 in a high-fat (H_Fat) diet, simultaneously with start of measurements (T₀); Expt. 2: the Mnt. diet at T₀ or 4 h postprandial (T₄); Expt. 3: T₄ at different ambient temperatures, 22°C and 15°C; Expt. 4: T₄ after 1 h physical activity. The RCO₂ and EEx were determined from the respiration chamber measurements made simultaneously with IC and the o¹³CBT (o¹³CBT_online), and in Expts. 1 and 2, also on two consecutive days using o¹³CBT with collection of breath into breath bags (o¹³CBT_breathbags). The RQ values obtained at T₀ reflected dietary compositions, with the highest least square mean (LSM) of 0.954  for the Mnt. diet, 0.905 for the H_Fibre and 0.877 for the H_Fat diet (p < 0.05). An increased interval between meal and measurement period decreased RQ significantly (p < 0.05) in Expt. 2, LSM being 0.954 at T₀ and 0.909 at T₄. Ambient temperature (Expt. 3) and physical activity (Expt. 4) did not influence postprandial RQ. The RF values were not significantly affected by diet (Expt. 1). Measurements starting at T₀ (Expt. 2) resulted in higher (p < 0.05) RF values than at T₄ (LSM = 0.971 and 0.836, respectively). The ambient temperatures (Expt. 3) did not influence postprandial RF. However, when dogs were physically active prior to measurements (Expt. 4), RF values (LSM = 1.019) were higher (p < 0.05) than when resting only (LSM = 0.836). Calculations based on RQ and RF determined in each experiment resulted in RCO₂ and EEx values which were not different regardless of method used, except for Expt. 1 where EEx-values [kJ · kg BW^-0.75 · d^-1] were higher (p < 0.05) when measured with o¹³CBT_breathbags (460) than by IC (421) and o¹³CBT_online (420). Provided accurate RQ and RF values, the o¹³CBT_breathbags can be used as an independent and minimally invasive research tool to determine EEx in dogs under carefully standardised conditions.

Effects of acute hypoventilation and hyperventilation on exhaled carbon monoxide measurement in healthy volunteers

Background

High levels of exhaled carbon monoxide (eCO) are a marker of airway or lung inflammation. We investigated whether hypo- or hyperventilation can affect measured values.

Methods

Ten healthy volunteers were trained to achieve sustained end-tidal CO2 (etCO2) concentrations of 30 (hyperventilation), 40 (normoventilation), and 50 mmHg (hypoventilation). As soon as target etCO2 values were achieved for 120 sec, exhaled breath was analyzed for eCO with a photoacoustic spectrometer. At etCO2 values of 30 and 40 mmHg exhaled breath was sampled both after a deep inspiration and after a normal one. All measurements were performed in two different environmental conditions: A) ambient CO concentration = 0.8 ppm and B) ambient CO concentration = 1.7 ppm.

Results

During normoventilation, eCO mean (standard deviation) was 11.5 (0.8) ppm; it decreased to 10.3 (0.8) ppm during hyperventilation (p < 0.01) and increased to 11.9 (0.8) ppm during hypoventilation (p < 0.01). eCO changes were less pronounced than the correspondent etCO₂ changes (hyperventilation: 10% Vs 25% decrease; hypoventilation 3% Vs 25% increase). Taking a deep inspiration before breath sampling was associated with lower eCO values (p < 0.01), while environmental CO levels did not affect eCO measurement.

Conclusions

eCO measurements should not be performed during marked acute hyperventilation, like that induced in this study, but the influence of less pronounced hyperventilation or of hypoventilation is probably negligible in clinical practice

1999 Jonathan E. Rhoads lecture. Isotopic metaprobes, nutrition, and the roads ahead

The 1999 Jonathan E. Rhoads lecture, delivered by Vernon R. Young at the annual meeting of American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), San Diego, February 2, 1999, with the printed version coauthored with Alfred M. Ajami, is concerned with the application of isotopic probes and how, in particular, they may be used as diagnostic tools to enhance the role of nutrition in the comprehensive medical management of the patient. Following a brief review of the early uses of stable isotopes in metabolic research we consider the present and possible future application of stable isotope probes. The concept of a "gateway" enzyme in a discrete biochemical pathway and how the flow of substrate through this step might be assessed by giving a "metaprobe" is developed. The specific and desirable structural requirements of the metaprobe are considered. A number of examples are given that further exploit the concepts of "underground" metabolism and of metabolic "hijackers." It is our view that we are on the verge of a new era where, for the many pragmatic and exciting reasons discussed, stable isotope probes will find and increasing use in the practice of clinical medicine and in the preventive and public health areas.