Increased carbon monoxide in exhaled air of critically ill patients

Heme oxygenase produces carbon monoxide (CO) during breakdown of heme molecules primarily in liver and spleen. Recent data suggest that CO is also produced in the lungs. CO is excreted by exhalation via the lungs. A number of inflammatory agents induce the expression of heme oxygenase, possibly leading to increased CO production. To investigate whether critical illness results in increased CO production we measured the CO concentration in exhaled air in 30 critically ill patients and in healthy controls (n = 6). Critically ill patients showed a significantly higher CO concentration in exhaled air (median 2.4 ppm, 95% CI 1.0-7.0 ppm vs median 1.55 ppm, 95% CI 1.2-1.7 ppm, P = 0.01) as well as total CO production (median 20 ml/min, 95% CI 8 to 90 ml/min vs median 13.5 ml/min, 95% CI 11 to 19 ml/min, P = 0.026) compared to healthy controls. No correlation was found between CO concentration in exhaled air and carboxyhemoglobin concentration in arterial and central venous blood (P > 0.05). The increase of CO concentration in exhaled air in critical illness suggests an induction of inducible heme oxygenase (HO-1) and might reflect the severity of illness.     

Effect of maximal dynamic exercise on exhaled ethane and carbon monoxide levels in human, equine, and canine athletes

Exercise-induced oxidative stress (EIOS) refers to a condition where the balance of free radical production and antioxidant systems is disturbed during exercise in favour of pro-oxidant free radicals. Breath ethane is a product of free radical-mediated oxidation of cell membrane lipids and is considered to be a reliable marker of oxidative stress. The heatshock protein, haem oxygenase, is induced by oxidative stress and degrades haemoglobin to bilirubin, with concurrent production of carbon monoxide (CO). The aim of this study was to investigate the effect of maximal exercise on exhaled ethane and CO in human, canine, and equine athletes. Human athletes (n = 8) performed a maximal exercise test on a treadmill, and canine (n = 12) and equine (n = 11) athletes exercised at gallop on a sand racetrack. Breath samples were taken at regular intervals during exercise in the human athletes, and immediately before and after exercise in the canine and equine athletes. Breath samples were stored in gas-impermeable bags for analysis of ethane by laser spectroscopy, and CO was measured directly using an electrochemical CO monitor. Maximal exercise was associated with significant increases in exhaled ethane in the human, equine, and canine athletes. Decreased concentrations of exhaled CO were detected after maximal exercise in the human athletes, but CO was rarely detectable in the canine and equine athletes. The ethane breath test allows non-invasive and real-time detection of oxidative stress, and this method will facilitate further investigation of the processes mediating EIOS in human and animal athletes.     

Predicting the carboxyhemoglobin levels resulting from carbon monoxide exposures.

Data from a series of human exposures to carbon monoxide (CO) were analyzed to determine the fit to the theoretical Coburn-Forster-Kane (CFK) equation which describes CO absorption and excretion. The equation was found to predict carboxyhemoglobin (HbCO) saturations for both men and women at exercise rates ranging from sedentary to 300 kpm/min when they were exposed to steady CO concentrations of 50, 100, and 200 ppm for 0.33-5.25 h. Methods for determining values of each of the variables in the CFK equation were collected and a rational, efficient procedure for solving the equation by trial and error was outlined. The CFK equation was then used to prepare a graph, relating HbCO saturation to exposure duration and concentration, and also to describe the effect of several variables on the rate of CO uptake and equilibrium HbCO levels, important considerations in the determination of permissible public, occupational, and experimental exposure to CO.     

Acute effects of cigarette smoking and inhalation of carbon monoxide during maximal exercise

The acute effect of inhaling the smoke of three cigarettes was compared to the effect of inhalation of an amount of carbon monoxide (CO), giving the same CO-saturation of the arterial blood as smoking during rest and during maximal exercise on a Krogh cycle ergometer. Sixteen male subjects were tested in the morning (1) after about 8 h without smoking (control), (2) after inhalation of the smoke of three cigarettes (smoke), and (3) after CO-inhalation (CO). It was found that the average maximal rate of O2-uptake (VO2 max) decreased during both smoke and CO by about 7%. Endurance time at VO2 max decreased 20% during smoke but only 10% during CO. A significant decrease in maximal heart rate (HR), and an increase in HR at rest, was demonstrated only during smoke. The peak lactate concentration (HLa) following maximal exercise was significantly decreased after smoke. The results suggest that the decrease in VO2 max during smoke is due to the CO-saturation of the blood, and hence to a decrease in the oxygen capacity of the blood, while the decrease in endurance time during smoke is combined effect of the CO-saturation and an increased cost of breathing caused by the smoke particles. It is further suggested that nicotine, or possibly some other components of the smoke, have an enhancing effect on the heart at rest rest, while an inhibition is seen during maximal exercise.(ABSTRACT TRUNCATED AT 250 WORDS)     

Photooxidative production of carbon monoxide by phototrophic microorganisms

Net photosynthesis and CO production were measured in cell suspensions of Chlorella fusca. The rate of net photosynthesis showed saturation curves with increasing radiation intensities and CO₂-mixing ratios. Maximum rates were found at 35° C with a sharp decrease at higher temperatures. By contrast, the rate of CO production was proportional to the radiation intensity and did not show any saturation up to 1.5 kW · m^?2 white light. The CO-production rate was higher in blue than in red light and was independent of the CO₂-mixing ratio of the carrier gas within a range of 0–1000 ppmv. We found that the CO-production rate was constant within the physiological temperature range of 10–35° C, but increased considerably at higher temperatures and that CO production by the chlorophyll-deficient mutant of C. fusca was 5 times that of the wild type. In addition, we measured CO production in cell suspensions of Chromatium vinosum, Rhodopseudomonas sphaeroides and Rhodopseudomonas acidophila, which were grown either anaerobically in the light or aerobically in the dark. CO production could only be observed when the cells were incubated in the presence of oxygen and light. Under these conditions more CO was produced by aerobically grown cells than by phototrophically grown cells of R. sphaeroides and R. acidophila. The results obtained indicate that CO was produced by photosensitized oxidations and not by metabolic processes.     

Mechanism of oxidation of carbon monoxide by bacteria

Double label experiments were performed employing ¹³CO and either H₂¹⁸O or ¹⁸O₂ in the presence of a CO utilizing bacterium. CO₂ generated was trapped and $\text{m}\text{e}$ ratios $\text{47}\text{45}$ showed that the second oxygen atom in the oxidation of CO to CO₂ by this bacterium comes neither from O₂ nor H₂O.     

The vasorelaxation of cerebral arteries by carbon monoxide

Carbon monoxide (CO) is known to increase cerebral blood flow, but the effect of CO on the vascular tone of large cerebral arteries is uncertain. We tested whether CO affects cerebral artery tone by measuring tension generated by ex vivo segments of dog basilar artery upon exposure to CO. In cerebral artery segments contracted with either KCl or prostaglandin F(2alpha), CO caused a concentration-related relaxation beginning with a concentration of 57 microM. Relaxation did not occur if CO was administered in the presence of bubbling carboxygen (95% O(2):5% CO(2)), which reduces greater than 99% of CO from the solution. Furthermore, the CO-induced relaxation of cerebral artery segments was reduced in the presence of the guanylyl cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 10 microM)or the potassium channel blocker tetraethylammonium (TEA, 1 mM). Neither ODQ nor TEA completely eliminated the relaxation caused by CO and there was no additive effect if ODQ and TEA were administered together. These results suggest that cerebral arteries are directly relaxed by CO and that this relaxation depends upon the activation of guanylyl cyclase and the opening of potassium channels.     

Association between smoking status and homocysteine levels and possible effect modification by cholesterol and oestradiol

Abstract

Introduction: This study aimed to examine the association of smoking status with homocysteine levels and to determine whether the association is modified by oestradiol or cholesterol.

Methods: Data (N?=?4580) were obtained from National Health and Nutrition Examination Survey 2003–2004 with analysis done in 2018 on adults aged ≥20 years. The outcome was homocysteine; smoking status was the exposure variable and categorized as current, former or never smoker. Generalized linear models were used to examine the associations between smoking status and homocysteine levels, while assessing the impact of oestradiol and cholesterol.

Results: After adjusting for age, sex, ethnicity, education and income level, homocysteine levels did differ by smoking status ((current smokers versus never smokers: β: 0.18?CI: 0.00, 0.36), (former smokers: β: 0.10?CI: –0.09, 0.28)). The addition of oestradiol as an interaction term in adjusted models was associated with a 16.6% increase in homocysteine levels when compared to models without the interaction term. Oestradiol but not cholesterol did moderate the association between smoking status and homocysteine levels.

Discussion and conclusions: Homocysteine levels did differ across smoking status after adjusting for confounders. Oestradiol did moderate the relationship between homocysteine and smoking status.     

A steady state method of measuring carbon monoxide diffusing capacity of the lung of sheep

A method for measuring the diffusing capacity of the lung for carbon monoxide (DLCO) in sheep was developed. The test's usefulness and reliability was studied in ten, splenectomized adult ewes. Hemoglobin concentration and weight were found to affect sheep DLCO. This article describes a method of determining DLCO in sheep, gives preliminary results of limited testing, and discusses factors affecting DLCO in sheep.     

Production of trace levels of carbon monoxide during methanogenesis on acetate and methanol

Summary Production of trace levels of carbon monoxide was consistently observed in the off-gas of a laboratory anaerobic digester fed Waste Activated Sludge. Inocula from this digester was enriched for acetate and methanol utilizing methanogenic populations. These enriched inocula were then monitored in batch assays for carbon monoxide and hydrogen production. Results demonstrated that carbon monoxide is produced during methanogenesis on both substrates. Subsequent utilization of CO was observed to occur after methane production was essentially complete for the assays conducted with methanol. Carbon monoxide evolution during methanogenesis on acetate displayed a markedly different trend from that observed from methanol.     

Predictions of carbon monoxide and blood carboxyhemoglobin levels from motor vehicles exhaust emissions

This study aims at predicting Carbon monoxide (CO) emission rate as well as carboxyhaemoglobin (HbCO) levelsin Al-Ain City, United Arab Emirates (UAE). Also, several mathematical models are proposed for estimating both CO emission and HbCO levels. These models yield excellent agreements between observed and predicted data and can be easily coupled with atmospheric models. Carbon monoxide exposure from motor vehicles were measured over a 3-month period from September to December 1995 at three locations in the UAE. The study is based on a sample of 148 cars. The data revealed that the major characteristics of the cars surveyed were as follows: 69.5% of the cars were Japanese, 74.3% of the cars were 5 years old; 41% of the car was range rover or four-wheel-drive car, which indicates a higher proportion of powerful cars; 58.8% was used special fuel; 51.4% had regular maintenance for their cars and 52% of the cars had 4 cylinder engine capacity. Carboxyhaemoglobin (HbCO) levels in the UAE were predicted for 1-hour (1.720 ppm) and 8-hour (8.106 ppm) exposure times. Also, on an average driving of 80 km hr–1 per day, the CO emission rate was found to be 8.729 ppm. These findings indicate that the mean 1-hour and 8-hour Carboxyhaemoglobin (HbCO) levels do not exceed the permissible standards recommended by the WHO. Additionally, the results of stepwise multiple regression analyses revealed that the factors, such as, type of car, size of cylinder, size of car, and maintaining service of the car exerted the greatest influence on the amount and concentration of pollutant emission produced by car exhaust.     

Studies on carbon monoxide binding by shark haemoglobin.

The kinetics of the reactions of Pacific-porbeagle haemoglobin with CO were studied by flash-photolysis and stopped-flow methods, and the equilibrium binding curves for CO were measured in spectrophotometric titrations. Measurements were made in the pH range 6-8 and in the temperature range 0-40 degrees C. The results are discussed in terms of the allosteric model proposed by Monod, Wyman & Changeux [(1965) J. Mol. Biol. 12, 88-118]. Within this framework the results indicate that in the R-state the haem groups fall into two classes of different reactivity with different spectral characteristics, but that in the T-state the groups may be essentially equivalent. The physiological importance of the temperature-insensitivity of the equilibrium ligand-binding curves for porbeagle haemoglobin is discussed.     

Heme oxygenase activity as measured by carbon monoxide production

A method is described for the in vitro determination of heme oxygenase (HO) activity in animal tissue preparations through determination of carbon monoxide production. Tissue homogenates were centrifuged and the 13,000g supernatants were incubated in septum-sealed vials with methemalbumin in the presence and absence of NADPH at 37 degrees C for 15 min. The reaction was terminated by quick-freezing to -78 degrees C and the amount of carbon monoxide released into the headspace was determined by gas chromatography with a reduction gas detector. The CO produced through mediation of NADPH is used as a measure of HO activity and is expressed as nanomoles of CO produced per hour per milligram protein. The method permits analysis of as little as 2 microliter normal rat tissue homogenate representing 0.4 mg liver tissue (approx 40 micrograms total protein). The assay rate is 10-15 duplicate samples per hour with a precision of 3% for sample (4.47 +/- 0.13 SD nmol CO/h/mg protein) and 6% for blank reactions (0.59 +/- 0.10 nmol CO/h/mg protein) for 10 microliter liver supernatant. Various reaction parameters were studied. The method was used to compare HO activity in several tissue homogenates from normal rats and rats treated with COCl2.