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Exhaled carbon monoxide screening for environmental tobacco smoke exposure in preanesthetic children

Danielle Dukellis1, Jeannie Zuk, Zhaoxing Pan

  • 1Department of Anesthesiology, The Children's Hospital and University of Colorado School of Medicine, Denver, Colorado, USA.

Paediatric Anaesthesia
|July 22, 2009
PubMed

Insights

Exhaled carbon monoxide (CO) is not a reliable preoperative screening tool for environmental tobacco smoke (ETS) exposure in young children. This is likely due to their limited ability to perform the necessary breathing maneuvers for accurate testing.

Area of Science:

  • Pediatric Anesthesiology
  • Environmental Health
  • Clinical Diagnostics

Background:

  • Environmental tobacco smoke (ETS) exposure increases perioperative risks in children.
  • Accurate preoperative screening for ETS exposure is crucial for patient safety.

Purpose of the Study:

  • To assess the utility of exhaled carbon monoxide (CO) as a preoperative screening tool for ETS exposure in children aged 6-15 years.

Main Methods:

  • A cohort of 501 children (aged 6-15) underwent ETS exposure assessment via questionnaire and urine cotinine levels.
  • Exhaled CO was measured using the EC50-Micro Smokerlyzer.
  • Correlation between exhaled CO, questionnaire, and urine cotinine was analyzed.

Main Results:

  • Exhaled CO measurements did not correlate with questionnaire-based or urine cotinine-based ETS exposure assessments.
  • Exhaled CO showed low sensitivity (10%) and moderate specificity (85%) in predicting elevated urine cotinine levels (>10).

Conclusions:

  • Exhaled CO, using the tested device, is not a suitable preoperative screening tool for ETS exposure in this pediatric population.
  • The inability of young children to perform adequate vital capacity maneuvers for end-tidal sampling may explain the poor performance.
Abstract

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