Improved gas chromatographic quantitation of breath hydrogen by normalization to respiratory carbon dioxide

A gas-solid chromatographic system using tandem silica gel and molecular sieve columns is described for the measurement of hydrogen, carbon dioxide, oxygen, and nitrogen in samples of respiratory gases. This system has a detection limit of 2 ppm of hydrogen in a 1 ml sample and can measure 120 ppm H2 and 5% CO2 with relative standard deviations of 1.3% and 1.7%, respectively. Improved sample storage and withdrawal techniques are described that give reproducible values for up to 6 weeks after collection. Finally we show that normalization of breath hydrogen values to an alveolar concentration, using the observed carbon dioxide concentrations, substantially reduces the range and variance of apparent H2 concentrations in human subjects. Normalization eliminates the need for rebreathing or end-expiratory collection techniques and substantially increases the reliability and clinical utility of hydrogen breath measurements in noninvasive tests of carbohydrate malabsorption.