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A sensitive analytical apparatus for measuring hydrogen production rates. II. Application to studies in human infants
Insights
Hydrogen (H2) production in healthy neonates shows significant variability, making breath H2 measurements challenging. Further research is needed to establish reliable interpretation methods for infant studies.
Area of Science:
- Neonatal Physiology
- Gastrointestinal Metabolism
- Respiratory Gas Analysis
Background:
- Assessing gastrointestinal function in neonates is crucial for understanding their health.
- Breath hydrogen (H2) analysis is a non-invasive method to evaluate intestinal bacterial activity and H2 production.
- Establishing reliable H2 measurement techniques in neonates is essential for accurate clinical interpretation.
Purpose of the Study:
- To estimate hydrogen (H2) production in healthy term and preterm neonates.
- To determine the end-tidal H2 concentration (ETH2) and pulmonary excretion rate (VeH2).
- To explore the correlation between ETH2 and VeH2 using different collection methods.
Main Methods:
- Simultaneous measurement of end-tidal H2 concentration (ETH2) and pulmonary excretion rate (VeH2).
- Study included healthy neonates (2 days to 7 weeks old) receiving enteral nutrition.
- Utilized nasopharyngeal catheter and nasal prong techniques for H2 collection.
Main Results:
- No distinct peak or pattern in H2 production was observed within 3 hours postprandially.
- Mean VeH2 was 1.00 ± 0.97 ml/kg/h and mean ETH2 was 40.3 ± 33.1 ppm.
- Marked short-term variability in ETH2 was frequently noted (CV = 13.4% ± 18.7%).
- VeH2 positively correlated with ETH2 (r=0.63-0.71, p<0.001) for both collection methods.
- Elevated H2 production was observed in neonates without malabsorption signs.
Conclusions:
- Breath hydrogen determinations in neonates are difficult to compare with studies in older individuals.
- Longitudinal studies in individual infants may help distinguish significant H2 excretion changes.
- Interpreting breath H2 measurements in human infants remains challenging due to moment-to-moment variations.
Abstract:
We estimated hydrogen (H2) production by determining simultaneously the end-tidal concentration (ETH2) and the direct pulmonary excretion rate (VeH2) in normal-sized, healthy, term and preterm neonates between 2 days and 7 weeks of life who were receiving all their calories enterally as breast milk or a proprietary formula. We found that there was no peak or pattern in H2 production during the first 3 postprandial hours (mean VeH2 = 1.00 +/- 0.97 SD ml/kg/h; mean ETH2 = 40.3 +/- 33.1 SD ppm). Frequently, there was marked short-term variability of the ETH2 in a given infant (coefficient of variation = 13.4% +/- 18.7%). H2 production was elevated in normal neonates without signs of malabsorption. We found that VeH2 correlated with ETH2 using both nasopharyngeal catheter (r = 0.63; p less than 0.001) and nasal prong (r = 0.71; p less than 0.001) collection techniques. We conclude that breath hydrogen determinations in neonates are not readily comparable to similar studies in older patients. Longitudinal studies of individual infants may reveal changes in breath H2 excretion of sufficient magnitude to be distinguishable from moment-to-moment variations, and correlatable with certain intercurrent clinical problems affecting intestinal H2 production or pulmonary H2 excretion. However, interpretation of breath H2 determinations in human infants will be difficult.