Major influence of oxygen supply on 13CO2:12CO2 ratio measurement by nondispersive isotope-selective infrared spectroscopy

BACKGROUND: The nondispersive isotope-selective infrared spectroscopy (NDIRS) is a valid method for the measurement of the 13CO2:12CO2 ratio in breath samples. Methodical influences have to be considered to obtain valid results. AIM: To evaluate the effect of oxygen supply to patients on the measurement of 13C:12C ratio in breath samples by NDIRS. METHODS: Breath samples of 26 healthy volunteers were taken before, immediately after, and 5 minutes after inhalation of 100% oxygen via a continuous positive air pressure (CPAP) mask. Analysis of breath samples was performed by NDIRS. RESULTS: Delta per thousand before oxygen inhalation was -25.8 +/- 0.2. Immediately after 5 minutes of 100% oxygen inhalation, delta per thousand increased to -14.8 +/- 0.5 (delta over baseline DOB] 11.0 +/- 0.4) and after additional 5 minutes of room air inhalation, delta per thousand normalized to -25.6 +/- 0.2 (DOB 0.2 +/- 0.1). CONCLUSIONS: Oxygen supply to patients and, therefore, changes in gas composition in breath samples clearly influence 13CO2 measurement by NDIRS. This has to be taken into account in the clinical setting. Thus, oxygen supply during measurement of exhaled 13CO2 by NDIRS has to be avoided or maintained at a strictly constant level.