Related Experiment Video

Updated: Jul 14, 2026

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
07:52

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department

Published on: January 29, 2011

End-tidal carbon monoxide levels in prematurely born infants developing bronchopulmonary dysplasia

Caroline May1, Sabina Patel, Janet Peacock

  • 1Division of Asthma, Allergy, and Biology, King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals, London, UK.

Pediatric Research
|May 23, 2007
PubMed

Insights

Elevated end-tidal carbon monoxide (ETCO) levels in premature infants may predict bronchopulmonary dysplasia (BPD). Higher ETCO readings on day 14 indicated a significant risk of developing BPD, characterized by oxygen dependency.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Biomarker Discovery

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in premature infants, linked to early inflammation.
  • Inflammatory processes can increase carbon monoxide (CO) production via heme oxygenase-1.
  • Elevated end-tidal CO (ETCO) levels are hypothesized to correlate with BPD development.

Purpose of the Study:

  • To investigate the association between serial ETCO measurements and the development of BPD in premature infants.
  • To determine if ETCO levels can serve as an early predictive biomarker for BPD.

Main Methods:

  • Serial ETCO measurements were taken on days 3, 5, 7, 14, 21, and 28 in 50 premature infants.
  • Infants were monitored for the development of BPD, defined as oxygen dependency at 36 weeks post-menstrual age (PMA).
  • Statistical analysis compared ETCO levels between infants who developed BPD and those who did not.

Main Results:

  • Infants who developed BPD exhibited significantly higher ETCO levels on days 7, 14, 21, and 28 compared to non-BPD infants.
  • On day 14, mean ETCO levels were 3.19 ppm in the BPD group versus 1.43 ppm in the non-BPD group (p<0.001).
  • An ETCO level >2.15 ppm on day 14 demonstrated 80% sensitivity and 92% specificity for predicting oxygen dependency at 36 weeks PMA.

Conclusions:

  • Serial ETCO measurements show promise as a non-invasive tool for early BPD prediction in premature infants.
  • Elevated ETCO levels may reflect the underlying inflammatory state associated with BPD development.
  • Further research could validate ETCO as a routine clinical biomarker for BPD risk stratification.

Related Concept Videos

Assessment of Diffusion and Perfusion01:17

Assessment of Diffusion and Perfusion

Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this principle...
Breathing01:05

Breathing

The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Oxygen Transport in the Blood01:27

Oxygen Transport in the Blood

Hemoglobin (Hb) is a crucial molecule in the human body, consisting of four polypeptide chains, each bound to an iron-containing heme group. This unique structure enables hemoglobin to bind to oxygen, with each molecule capable of combining with four molecules of oxygen, leading to rapid and reversible oxygen loading. When fully loaded with oxygen, it is called oxyhemoglobin, while hemoglobin that has released oxygen is called reduced hemoglobin or deoxyhemoglobin. As hemoglobin binds oxygen,...
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Atelectasis II: Pathophysiology01:10

Atelectasis II: Pathophysiology

Atelectasis develops when alveoli lose their air and collapse inward. Because lung tissue is naturally elastic, these air sacs shrink rather than remaining open. Collapsed alveoli are no longer ventilated, reducing their role in gas exchange. Blood flow may continue in these regions, creating a ventilation–perfusion mismatch. Clinical findings include decreased breath sounds, dullness to percussion, reduced chest expansion, and decreased tactile fremitus as sound transmission through collapsed...