End‐tidal carbon monoxide measurements in infant respiratory distress syndrome

Krediet, Tannette G.; Cirkel, Geert A.; Vreman, Hendrik J.; Wong, Ronald J.; Stevenson, David K.; Groenendaal, Floris; Egberts, J.; Bel, Frank van

doi:10.1080/08035250500537017

Cited by 20 publications

(32 citation statements)

References 23 publications

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“…Simultaneously, blood was sampled for MDA, IL-6 and IL-8. The method to measure ETCOc was described previously [6,16,17] . Briefly, this noninvasive bedside instrument uses electrochemical sensors for measurement of CO, and an infrared optical bench for measurement of end-tidal carbon dioxide.…”

Section: Methodsmentioning

confidence: 99%

Oxidative Stress and Proinflammatory Cytokine Levels are Increased in Premature Neonates of Preeclamptic Mothers with HELLP Syndrome

Torrance

Krediet²,

Vreman³

et al. 2008

Neonatology

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Background: Respiratory distress syndrome (RDS) incidence is increased in infants of preeclamptic mothers with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. RDS and HELLP syndrome have been associated with oxidative stress and inflammatory processes. Objectives: We hypothesize that end-tidal carbon monoxide corrected for inhaled CO (ETCOc), malondialdehyde (MDA) (markers of oxidative stress) and proinflammatory cytokine (IL-6, IL-8) production are higher in infants of preeclamptic mothers with HELLP syndrome than in those of preeclamptic mothers without HELLP syndrome. Methods: Prospective study of 36 infants of preeclamptic mothers (GA <32 weeks) admitted to the Neonatal Intensive Care Unit. ETCOc was measured at 0–12, 48–72 and 168 h postnatally using the CO-Stat™ End-Tidal Breath Analyzer. Simultaneously, blood was sampled for MDA, IL-8 and IL-6. Results: At 0–12 h, ETCOc, MDA and IL-8 values (median[range]) were significantly higher in HELLP infants than in infants from preeclamptic mothers without HELLP (ETCOc 2.2 [1.5–3.9] vs. 1.8 [0.5–2.9] ppm; MDA 2.3 [1.3–4.1] vs. 1.5 [0.4–3.1] µmol/l; IL-8 145 [24–606] vs. 62 [26–397] pg/ml; all p <0.05). MDA remained significantly higher during the first 168 h of life (2.3 [0.8–5.8] vs. 1.1 [0.8–3.7] µmol/l, p = 0.02). Conclusion: Oxidative stress and proinflammatory cytokine levels are increased in infants of preeclamptic mothers with HELLP syndrome. These processes may cause inactivation of surfactant explaining the increased RDS incidence in these infants.

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Section: Methodsmentioning

confidence: 99%

Oxidative Stress and Proinflammatory Cytokine Levels are Increased in Premature Neonates of Preeclamptic Mothers with HELLP Syndrome

Torrance

Krediet²,

Vreman³

et al. 2008

Neonatology

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“…The higher ETCOc values in these infants compared with the values in infants without hsPDA suggest the presence of a vasodilatory circulatory state. Since earlier studies already revealed an association between severe RDS and increased values for ETCOc [10], it is conceivable that the infants are in a pro-inflammatory state, resulting in preterm birth, severe RDS and development of hsPDA. However, the vasodilatory state could not be confirmed by higher blood pressure support scores in these infants.…”

Section: Discussionmentioning

confidence: 99%

“…In infants with spontaneous ventilation the nasal sampler was inserted approximately 5 mm into the nostril. In case of mechanical ventilation the sampler was inserted into the proximal part of the endotracheal tube via a T-connector [10]. With the COCO 2 Puff, a device comparable to the Natus CO-Stat™ End Tidal Breath Analyzer (Natus Medical, Inc., San Carlos, Calif., USA) ETCOc, ETCO 2 and ventilatory rate were measured non-invasively at the bedside [7].…”

Section: Methodsmentioning

confidence: 99%

“…ETCOc measurements were performed in duplo and the mean was used for the study. ETCOc values <2.5 ppm were considered to be within the normal range [10]. Since maternal smoking may affect CO concentration in the fetus, infants who were exposed to maternal smoking were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…Earlier studies have shown that ETCOc is a useful parameter in the prediction of chronic lung disease [8,9,10] and adverse neurodevelopmental outcome [11] and it is suggested that ETCOc is associated with inflammation and oxidative stress. Since the majority of preterm infants with severe RDS have a persistent PDA, it is hypothesized that measurement of ETCOc during the first days of life may yield increased levels of ETCOc, indicating increased endogenous CO production, triggered by the RDS-related pro-inflammatory state.…”

Section: Introductionmentioning

confidence: 99%

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Early End-Tidal Carbon Monoxide Levels, Patency of the Ductus Arteriosus and Regional Cerebral Oxygenation in Preterm Infants

Dix¹,

Blok²,

Lemmers³

et al. 2013

Neonatology

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Background: Carbon monoxide (CO), a relaxant regulator of muscle tone and marker of oxidative stress and inflammation, can be measured in exhaled air by determination of end-tidal CO corrected for CO in ambient air (ETCOc). Objective: Increased endogenous production of CO may influence patency of the ductus arteriosus, cerebral perfusion and, subsequently, cerebral oxygenation. The aim was to study the relation between early ETCOc levels, hemodynamically significant patent ductus arteriosus (hsPDA) and cerebral oxygenation (rScO₂) in preterm infants <32 weeks' gestational age and determine predictive values of ETCOc for hsPDA. Methods: ETCOc was measured in 91 infants within the first 24 h after birth. A hsPDA was diagnosed according to echocardiographic indices. In 78/91 infants, rScO₂ was monitored with near-infrared spectroscopy to assess cerebral oxygenation. Results: ETCOc values were significantly higher in infants who subsequently developed hsPDA (2.3 ± 0.7 ppm) vs. no-hsPDA (1.7 ± 0.6 ppm), p < 0.001. With a cut-off value of 2.5 ppm, positive and negative predictive values of ETCOc for hsPDA were 55 and 88%, respectively. rScO₂ values were not different between the two groups (64 ± 1 vs. 65 ± 3%, NS). Conclusions: The higher ETCOc values in hsPDA infants early after birth reflect the early relaxant state of ductal muscular tone. ETCOc <2.5 ppm within 24 h after birth may predict the subsequent absence of hsPDA. ETCOc showed no correlation with cerebral oxygenation in both groups.

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Oxidative Stress in Low Birth Weight Newborns

Negi

Pande

Karki

et al. 2014

Free Radicals in Human Health and Disease

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Free radical damage has been recognized to be a common pathogenic mechanism of many neonatal diseases. An excessive and/or sustained increase in free radical production associated with diminished effi cacy of the antioxidant defense systems results in oxidative stress, which occurs in many pathologic processes and contributes signifi cantly to disease and can be the key link between size at birth and increased morbidity later in life. Low birth weight is closely associated with fetal and neonatal mortality and morbidity, inhibited growth and cognitive development, and chronic diseases later in life. Low birth weight is considered the primary factor associated with a poor perinatal outcome of maternal preeclampsia/ eclampsia and premature birth. High oxidative stress and low level of enzymatic antioxidants and antioxidant nutrients such as vitamins A, E, and C, zinc, copper, and selenium and antioxidant status might be increasing the risk of pathogenesis of major complications in low birth weight newborns.

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End‐tidal carbon monoxide measurements in infant respiratory distress syndrome

Abstract: 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.

Cited by 20 publications

References 23 publications

Oxidative Stress and Proinflammatory Cytokine Levels are Increased in Premature Neonates of Preeclamptic Mothers with HELLP Syndrome

Oxidative Stress and Proinflammatory Cytokine Levels are Increased in Premature Neonates of Preeclamptic Mothers with HELLP Syndrome

Early End-Tidal Carbon Monoxide Levels, Patency of the Ductus Arteriosus and Regional Cerebral Oxygenation in Preterm Infants

Oxidative Stress in Low Birth Weight Newborns

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