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Water vapour and carbon dioxide decrease nitric oxide readings

T W van der Mark1, E Kort, R J Meijer

  • 1Dept of Pulmonology, University Hospital Groningen, The Netherlands.

The European Respiratory Journal
|October 6, 1997
PubMed
Summary
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Water vapor significantly underestimates nitric oxide (NO) measurements in exhaled air using chemiluminescence. Carbon dioxide (CO2) also affects readings, especially at high concentrations.

Area of Science:

  • Respiratory physiology
  • Analytical chemistry

Background:

  • Nitric oxide (NO) measurement in exhaled air is crucial for diagnosing respiratory conditions.
  • Chemiluminescence detectors are commonly used but can be affected by exhaled gases.
  • The impact of water vapor and carbon dioxide (CO2) on NO readings at physiological concentrations is not well understood.

Purpose of the Study:

  • To investigate the in vitro effects of water vapor and CO2 on nitric oxide (NO) measurements using a chemiluminescence detector.
  • To quantify the underestimation of NO levels caused by water vapor in exhaled air.
  • To assess the influence of varying CO2 concentrations on NO readings.

Main Methods:

  • Prepared in vitro gas mixtures of NO (50-200 ppb) in air, with and without water vapor saturation.

Related Experiment Videos

  • Introduced varying concentrations of CO2 (0-10%) into NO-air mixtures.
  • Measured NO levels using a chemiluminescence analyser, comparing readings under different conditions.

    • Main Results:

    • Water-saturated NO samples showed a significant decrease in readings compared to dry samples (p < 0.001).
    • Exhaled NO levels (mean 10 ± 2 ppb) decreased by 17 ± 3% due to unabsorbed water vapor.
    • CO2 caused a decrease of 1.04 ± 0.07% per volume CO2 (%), with negligible effects at normal respiratory levels but substantial effects at high CO2 concentrations.

    Conclusions:

    • Water vapor leads to systematic underestimation of NO levels in exhaled air, suggesting the utility of water absorbers.
    • CO2 influence is minimal at typical respiratory concentrations but significant during permissive hypercapnia.
    • Accurate NO measurement requires accounting for water vapor and, in specific clinical scenarios, CO2 interference.