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J Appl Physiol (May 14, 2009). doi:10.1152/japplphysiol.90913.2008
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Submitted on July 15, 2008
Revised on April 30, 2009
Accepted on May 11, 2009

Adaptation of the NDIR-technology to 13CO2-breath tests under increased inspiratory O2 concentrations

Josef Albert Vogt1*, Ulrich Wachter1, Jürgen Mehring2, Peter Radermacher3, Michael Georgieff1, Heinz Fischer4, Uvo Hölscher2, Michael Möde5, and Walter Fabinski5

1 University Hospital Ulm
2 Münster University of applied Science
3 Universitaetsklinikum
4 Fischer Analysen GmbH, Frankfurt Germany
5 ABB Automation GmbH, Frankfurt Germany

* To whom correspondence should be addressed. E-mail: josef.vogt{at}uni-ulm.de.

NDIR (nondispersive infrared spectroscopy) allows the continuous analysis of respiratory gases. Due to its high selectivity, simple and robust set up and small footprint, it is also used to support 13CO2-breath tests to assess bacterial growth in the stomach, gut or liver function. CO2 NDIR signals, however, are biased by oxygen in the gas matrix. This complicates NDIR based breath tests, if the inspired oxygen concentration has to be adjus­ted to the subjects requirements or hyperoxia induced effects were studied. To avoid the oxygen-induced bias, a "dilution" approach was de­veloped; expired gas is mixed with N2 to lower the oxygen content down to the usual range of 15%-20%. Accuracy and precision were tested using synthetic gas mix­tures with increasing 13CO2 / 12CO2 ratios, either based on synthetic air with about 20 %Vol O2 or on pure O2 . For samples with {delta}13C values smaller 300 (or 13CO2 / 12CO2 ratios smaller 0.003) the dilution does not significantly increase the bias in the 13CO2 / 12CO2 ratio determination and the within-run imprecision is smaller 1 {delta}13C. The practical use of this approach was validated in a pig study using a sepsis model reflecting a clinical situation that requires an increased oxygen concentration for respiration. The N2-dilution eliminated the high bias in NDIR- measurement thus allowing to determine the impact of oxygenation on glucose oxidation in patients ventilated with increased oxygen.







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