First-pass effect of an intravenous bolus of [13C]bicarbonate displayed breath-by-breath

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.

Interpretation of non-invasive breath tests using (13)C-labeled substrates--a preliminary report with (13)C-methacetin

Non-invasive breath tests can serve as valuable diagnostic tools in medicine as they can determine particular enzymatic and metabolic functions in vivo. However, methodological pitfalls have limited the actual clinical application of those tests till today. A major challenge of non-invasive breath tests has remained the provision of individually reliable test results. To overcome these limitations, a better understanding of breath kinetics during non-invasive breaths tests is essential. This analysis compares the breath recovery of a ¹³C-methacetin breath test with the actual serum kinetics of the substrate. It is shown, that breath and serum kinetics of the same test are significantly different over a period of 60 minutes. The recovery of the tracer ¹³CO₂ in breath seems to be significantly delayed due to intermediate storage in the bicarbonate pool. This has to be taken into account for the application of non-invasive breath test protocols. Otherwise, breath tests might display bicarbonate kinetics despite the metabolic capacity of the particular target enzyme.

Factors affecting 13C-natural abundance measurement of breath carbon dioxide during surgery: absorption of carbon dioxide during endoscopic procedures

The aim of this paper is to review the factors which may affect breath (13)CO(2)/(12)CO(2) natural abundance in patients undergoing surgery or intensive care. Intravenous glucose administration is a major determinant of the (13)CO(2)/(12)CO(2) of breath as intravenous glucose preparations are almost all derived from cornstarch. In addition, the oxidation of endogenous substrates can affect the (13)CO(2)/(12)CO(2) ratio. During many endoscopic procedures, such as laparoscopic surgery, carbon dioxide insufflation is used to provide a working space. As medical CO(2) is relatively depleted in (13)CO(2) compared with endogenous and exogenous metabolic CO(2) sources, breath (13)CO(2)/(12)CO(2) measurements can be used to estimate CO(2) absorption during these procedures. However, all these factors may also be affected by the bicarbonate pool, making a definitive attribution of changes in breath (13)CO(2)/(12)CO(2) to a single factor problematic.