The correlation between breath acetone and blood betahydroxybutyrate in individuals with type 1 diabetes.

Ketone testing is an important element of the self-management of illness in type 1 diabetes. The aim of the present study was to see if a breath test for acetone could be used to predict quantitatively the levels of the ketone betahydroxybutyrate in the blood of those with type 1 diabetes, and thus be used as an alternative to capillary testing for ketones. Simultaneous capillary ketones and breath acetone were measured in 72 individuals with type 1 diabetes attending a diabetes clinic and on 9 individuals admitted to hospital with diabetic ketoacidosis. Capillary blood measurements ranged from 0.1 mmol l-1 (the lower limit of the ketone monitor) to over 7 mmol l-1, with breath acetone varying between 0.25 and 474 parts per million by volume. The two variables were found to be correlated and allowed modelling to be carried out which separated breath acetone levels into three categories corresponding to normal, elevated and 'at risk' levels of blood ketones. The results on this limited set of participants suggest that a breath acetone test could be a simple, non-invasive substitute for capillary ketone measurement in type 1 diabetes.

Accurate real-time FENO expirograms using complementary optical sensors.

The fraction of exhaled nitric oxide (FENO) is an important biomarker for the diagnosis and management of asthma and other pulmonary diseases associated with airway inflammation. In this study we report on a novel method for accurate, highly time-resolved, real time detection of FENO at the mouth. The experimental arrangement is based on a combination of optical sensors for the determination of the temporal profile of exhaled NO and CO2 concentrations. Breath CO2 and exhalation flow are measured at the mouth using diode laser absorption spectroscopy (at 2 µm) and differential pressure sensing, respectively. NO is determined in a sidestream configuration using a quantum cascade laser based, cavity-enhanced absorption cell (at 5.2 µm) which simultaneously measures sidestream CO2. The at-mouth and sidestream CO2 measurements are used to enable the deconvolution of the sidestream NO measurement back to the at-mouth location. All measurements have a time resolution of 0.1 s, limited by the requirement of a reasonable limit of detection for the NO measurement, which on this timescale is 4.7 ppb (2 σ). Using this methodology, NO expirograms (FENOgrams) were measured and compared for eight healthy volunteers. The FENOgrams appear to differ qualitatively between individuals and the hope is that the dynamic information encoded in these FENOgrams will provide valuable additional insight into the location of the inflammation in the airways and potentially predict a response to therapy. A validation of the measurements at low-time resolution is provided by checking that results from previous studies that used a two-compartment model of NO production can be reproduced using our technology.

High-resolution absorption studies of the A(1)A2-X(1)A1 2(0)(2)4(0)(1) band of formaldehyde.

Absolute peak absorption cross sections and pressure broadening coefficients have been recorded with sub-Doppler limited instrumental resolution for selected rotational lines in the 2(0)(2)4(0)(1) vibronic band of the formaldehyde A(1)A2-X(1)A1 electronic transition. The measured absorption cross sections range between (0.18 +/- 0.01) and (10.1 +/- 0.08) x 10(-19) cm2 molecule(-1) and are considerably larger than values from the literature recorded using apparatus where instrumental broadening was significant. However, comparisons with spectral simulations with equivalent resolution from Smith et al. (J. Phys. Chem. A 2006, 110, 11645-11653) are in excellent agreement. Pressure broadening was studied for the collision partners CH2O, CO2, N2, O2, Ne, Kr, Ar, and He, and the resulting broadening coefficients were found to be reduced in comparison to equivalent values measured in infrared regions, consistent with the reduced dipole moment of the upper state probed in this work. Cavity-enhanced absorption spectroscopy (CEAS) measurements were undertaken using calibrated low concentration (2.9-4.6 ppmv) samples from a permeation source and demonstrate a noise equivalent absorption of 1.2 x 10(-6) cm(-1) Hz(-1/2). This implies a minimum detectable formaldehyde concentration with the current system in atmospheric air of 172 ppbv Hz(-1/2).

Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes.

Previous studies have suggested that breath gases may be related to simultaneous blood glucose and blood ketone levels in adults with type 2 and type 1 diabetes. The aims of this study were to investigate these relationships in children and young people with type 1 diabetes in order to assess the efficacy of a simple breath test as a non-invasive means of diabetes management. Gases were collected in breath bags and measurements were compared with capillary blood glucose and ketone levels taken at the same time on a single visit to a routine hospital clinic in 113 subjects (59 male, age 7 years 11 months-18 years 3 months) with type 1 diabetes. The patients were well-controlled with relatively low concentrations of the blood ketone measured (ß hydroxybutyrate, 0-0.4 mmol l(-1)). Breath acetone levels were found to increase with blood ß hydroxybutyrate levels and a significant relationship was found between the two (Spearman's rank correlation ρ = 0.364, p < 10(-4)). A weak positive relationship was found between blood glucose and breath acetone (ρ = 0.16, p = 0.1), but led to the conclusion that single breath measurements of acetone do not provide a good measure of blood glucose levels in this cohort. This result suggests a potential to develop breath gas analysis to provide an alternative to blood testing for ketone measurement, for example to assist with the management of type 1 diabetes.

Laser-based absorption spectroscopy as a technique for rapid in-line analysis of respired gas concentrations of O2 and CO2.

The use of sidestream analyzers for respired gas analysis is almost universal. However, they are not ideal for measurements of respiratory gas exchange because the analyses are both temporally dissociated from measurements of respiratory flow and also not generally conducted under the same physical conditions. This study explores the possibility of constructing an all optical, fast response, in-line breath analyzer for oxygen and carbon dioxide. Using direct absorption spectroscopy with a diode laser operating at a wavelength near 2 µm, measurements of expired carbon dioxide concentrations were obtained with an absolute limit of detection of 0.04% at a time resolution of 10 ms. Simultaneously, cavity enhanced absorption spectroscopy at a wavelength near 760 nm was employed to obtain measurements of expired oxygen concentrations with an absolute limit of detection of 0.26% at a time resolution of 10 ms. We conclude that laser-based absorption spectroscopy is a promising technology for in-line analysis of respired carbon dioxide and oxygen concentrations.