Laser spectroscopy for breath analysis: towards clinical implementation

Baseline correction for the infrared spectra of exhaled breath

Infrared spectroscopy appears to be a promising analytical method for the metabolic analysis of breath. However, due to the presence of trace amounts in exhaled breath, the absorption strength of the metabolites remains extremely low. In such low detection limits, the nonlinear detection sensitivity of the infrared detector and electronic noise strongly modify the baseline of the acquired infrared spectra of breath. Fitting the reference molecular spectra with the baseline-modified spectral features of breath metabolites does not provide accurate identification. Therefore, baseline correction of the acquired infrared spectra of breath is the primary requirement for the success of breath-based infrared diagnosis. A selective spectral region-based, simple baseline correction method is proposed for the infrared spectroscopy of breath.

Effect of gas turbulence in quartz-enhanced photoacoustic spectroscopy: A comprehensive flow field analysis

Here we present a computational and experimental fluid dynamics study for the characterization of the flow field within the gas chamber of a Quartz-Enhanced Photoacoustic Spectroscopy (QEPAS) sensor, at different flow rates at the inlet of the chamber. The transition from laminar to turbulent regime is ruled both by the inlet flow conditions and dimension of the gas chamber. The study shows how the distribution of the flow field in the chamber can influence the QEPAS sensor sensitivity, at different operating pressures. When turbulences and eddies are generated within the gas chamber, the efficiency of photoacoustic generation is significantly altered.

Ultra-highly sensitive dual gases detection based on photoacoustic spectroscopy by exploiting a long-wave, high-power, wide-tunable, single-longitudinal-mode solid-state laser

Photoacoustic spectroscopy (PAS) as a highly sensitive and selective trace gas detection technique has extremely broad application in many fields. However, the laser sources currently used in PAS limit the sensing performance. Compared to diode laser and quantum cascade laser, the solid-state laser has the merits of high optical power, excellent beam quality, and wide tuning range. Here we present a long-wave, high-power, wide-tunable, single-longitudinal-mode solid-state laser used as light source in a PAS sensor for trace gas detection. The self-built solid-state laser had an emission wavelength of ~2 μm with Tm:YAP crystal as the gain material, with an excellent wavelength and optical power stability as well as a high beam quality. The wide wavelength tuning range of 9.44 nm covers the absorption spectra of water and ammonia, with a maximum optical power of ~130 mW, allowing dual gas detection with a single laser source. The solid-state laser was used as light source in three different photoacoustic detection techniques: standard PAS with microphone, and external- and intra-cavity quartz-enhanced photoacoustic spectroscopy (QEPAS), proving that solid-state laser is an attractive excitation source in photoacoustic spectroscopy.

Ultra-broadband spectroscopy using a 2-11.5 µm IDFG-based supercontinuum source

Supercontinuum sources based on intrapulse difference frequency generation (IDFG) from mode-locked lasers open new opportunities in mid-infrared gas spectroscopy. These sources provide high power and ultra-broadband spectral coverage in the molecular fingerprint region with very low relative intensity noise. Here, we demonstrate the performance of such a light source in combination with a multipass cell and a custom-built Fourier transform spectrometer (FTS) for multispecies trace gas detection. The light source provides a low-noise, ultra-broad spectrum from 2-11.5 µm with ∼3 W output power, outperforming existing mid-infrared supercontinuum sources in terms of noise, spectral coverage, and output power. This translates to an excellent match for spectroscopic applications, establishing (sub-)ppb sensitivity for molecular hydrocarbons (e.g., CH4, C2H4), oxides (e.g., SO2, NOx), and small organic molecules (e.g., acetone, ethyl acetate) over the spectral range of the supercontinuum source with a measurement time varying from seconds to minutes. We demonstrate a practical application by measuring the off-gas composition of a bioreactor containing an acidic ammonia-oxidizing culture with the simultaneous detection of multiple nitrogen oxides (NO, NO2, N2O, etc.). As the different species absorb various parts of the spectrum, these results highlight the functionality of this spectroscopic system for biological and environmental applications.

Machine learning enabled detection of COVID-19 pneumonia using exhaled breath analysis: a proof-of-concept study

Detection of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) relies on real-time-reverse-transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal swabs. The false-negative rate of RT-PCR can be high when viral burden and infection is localized distally in the lower airways and lung parenchyma. An alternate safe, simple and accessible method for sampling the lower airways is needed to aid in the early and rapid diagnosis of COVID-19 pneumonia. In a prospective unblinded observational study, patients admitted with a positive RT-PCR and symptoms of SARS-CoV-2 infection were enrolled from three hospitals in Ontario, Canada. Healthy individuals or hospitalized patients with negative RT-PCR and without respiratory symptoms were enrolled into the control group. Breath samples were collected and analyzed by laser absorption spectroscopy (LAS) for volatile organic compounds (VOCs) and classified by machine learning (ML) approaches to identify unique LAS-spectra patterns (breathprints) for SARS-CoV-2. Of the 135 patients enrolled, 115 patients provided analyzable breath samples. Using LAS-breathprints to train ML classifier models resulted in an accuracy of 72.2%-81.7% in differentiating between SARS-CoV2 positive and negative groups. The performance was consistent across subgroups of different age, sex, body mass index, SARS-CoV-2 variants, time of disease onset and oxygen requirement. The overall performance was higher than compared to VOC-trained classifier model, which had an accuracy of 63%-74.7%. This study demonstrates that a ML-based breathprint model using LAS analysis of exhaled breath may be a valuable non-invasive method for studying the lower airways and detecting SARS-CoV-2 and other respiratory pathogens. The technology and the ML approach can be easily deployed in any setting with minimal training. This will greatly improve access and scalability to meet surge capacity; allow early and rapid detection to inform therapy; and offers great versatility in developing new classifier models quickly for future outbreaks.

COVID-19: An overview on possible transmission ways, sampling matrices and diagnosis

COVID-19 is an RNA virus belonging to the SARS family of viruses and includes a wide range of symptoms along with effects on other body organs in addition to the respiratory system. The high speed of transmission, severe complications, and high death rate caused scientists to focus on this disease. Today, many different investigation types are performed on COVID-19 from various points of view in the literature. This review summarizes most of them to provide a useful guideline for researchers in this field. After a general introduction, this review is divided into three parts. In the first one, various transmission ways COVID-19 are classified and explained in detail. The second part reviews the used biological samples for the detection of virus and the final section describes the various methods reported for the diagnosis of COVID-19 in various biological matrices.

Mid-infrared optical frequency comb spectroscopy using an all-silica antiresonant hollow-core fiber

We present the first mid-infrared optical frequency comb spectrometer employing an absorption cell based on self-fabricated, all-silica antiresonant hollow-core fiber (ARHCF). The spectrometer is capable of measuring sub-mL sample volumes with 26 m interaction length and noise equivalent absorption sensitivity of 8.3 × 10-8 cm-1 Hz-1/2 per spectral element in the range of 2900 cm-1 to 3100 cm-1. Compared to a commercially available multipass cell, the ARHCF offers a similar interaction length in a 1000 times lower gas sample volume and a 2.8 dB lower transmission loss, resulting in better absorption sensitivity. The broad transmission windows of ARHCFs, in combination with a tunable optical frequency comb, make them ideal for multispecies detection, while the prospect of measuring samples in small volumes makes them a competitive technique to photoacoustic spectroscopy along with the robustness and prospect of coiling the ARHCFs open doors for miniaturization and out-of-laboratory applications.

Comb spectroscopy of CO2 produced from microbial metabolism

We have developed a direct frequency comb spectroscopy instrument, which we have tested on Saccharomyces cerevisiae (baker's yeast) by measuring its CO2 output and production rate as we varied the environmental conditions, including the amount and type of feed sugar, the temperature, and the amount of yeast. By feeding isotopically-enhanced sugar to the yeast, we demonstrate the capability of our device to differentiate between two isotopologues of CO2, with a concentration measurement precision of 260 ppm for 12C16O2 and 175 ppm for 13C16O2. We also demonstrate the ability of our spectrometer to measure the proportion of carbon in the feed sugar converted to CO2, and estimate the amount incorporated into the yeast biomass.

SARS CoV-2 infection screening via the exhaled breath fingerprint obtained by FTIR spectroscopic gas-phase analysis. A proof of concept

The COVID-19 pandemic remains a global challenge now with the long-COVID arising. Mitigation measures focused on case counting, assessment and determination of variants and their likely targets of infection and transmission, the pursuit of drug treatments, use and enhancement of masks, social distancing, vaccination, post-infection rehabilitation, and mass screening. The latter is of utmost importance given the current scenario of infections, reinfections, and long-term health effects. Research on screening platforms has been developed to provide more sensitive, specific, and reliable tests that are accessible to the entire population and can be used to assess the prognosis of the disease as well as the subsequent health follow-up of patients with sequelae of COVID-19. Therefore, the aim of the present study was the simulation of exhaled breath of COVID-19 patients by evaluation of three identified COVID-19 indicator breath biomarkers (acetone (ACE), acetaldehyde (ACH) and nitric oxide (NO)) by gas-phase infrared spectroscopy as a proof-of-concept principle for the detection of infected patients' exhaled breath fingerprint and subsequent follow-up. The specific fingerprints of each of the compounds and the overall fingerprint were obtained. The synthetic exhaled breath evaluation concept revealed a linearity of r = 0.99 for all compounds, and LODs of 6.42, 13.81, 9.22 ppm, and LOQs of 42.26, 52.57, 69.23 ppm for NO, ACE, and ACH, respectively. This study proves the fundamental feasibility of gas-phase infrared spectroscopy for fingerprinting lung damage biomarkers in exhaled breath of patients with COVID-19. This analysis would allow faster and cheaper screening and follow-up of infected individuals, which could improve mass screening in POC settings.

TDLAS-based water vapor monitoring in narrow channels of polymer electrolyte fuel cells using a single-ended fiber-optic sensor

The dehydration of electrolyte membranes in polymer electrolyte fuel cells (PEFCs) operating under low-humidity conditions is a critical issue for achieving their high efficiency and high power density. To reduce the membrane dryout, it's necessary to investigate and control the water transport within working fuel cells. This study developed a single-ended fiber-optic sensor based on tunable diode laser absorption spectroscopy (TDLAS) and applied it to the real-time monitoring of the water vapor concentration in the narrow flow channel of a PEFC. The newly proposed wavelength modulation spectroscopy (WMS) technique enabled to quantify the mole fraction of water in the channel over the wide concentration range with high accuracy. The in-situ TDLAS measurement in the PEFC during a low-humidity and load-change operation revealed that the dynamic change of cell voltage is strongly correlated to the dry-wet transition in the anode channel.

Low-frequency regular pulse and intermittent oscillation in a mid-infrared interband cascade laser with optoelectronic feedback

In this work, we experimentally investigate the nonlinear dynamics of a mid-infrared interband cascade laser (ICL) subject to optoelectronic feedback (OEF) through inspecting the time series and power spectrum of the laser output. The results show that, within the range of feedback strength limited by the experiment condition, the ICL sequentially presents stable state, continuously periodical oscillation (CPO), low-frequency regular pulse (LF-RP) and intermittent oscillation state with the increase of feedback strength. For the LF-RP state, the peak-to-peak value and the oscillation period increase with the increase of feedback strength. For the intermittent oscillation state, the time series is composed of the laminar region and burst region appeared alternately, and the average value and standard deviation for the duration of burst region gradually decrease with the increase of feedback strength.

Dual-comb optomechanical spectroscopy

Optical cavities are essential for enhancing the sensitivity of molecular absorption spectroscopy, which finds widespread high-sensitivity gas sensing applications. However, the use of high-finesse cavities confines the wavelength range of operation and prevents broader applications. Here, we take a different approach to ultrasensitive molecular spectroscopy, namely dual-comb optomechanical spectroscopy (DCOS), by integrating the high-resolution multiplexing capabilities of dual-comb spectroscopy with cavity optomechanics through photoacoustic coupling. By exciting the molecules photoacoustically with dual-frequency combs and sensing the molecular-vibration-induced ultrasound waves with a cavity-coupled mechanical resonator, we measure high-resolution broadband ( > 2 THz) overtone spectra for acetylene gas and obtain a normalized noise equivalent absorption coefficient of 1.71 × 10-11 cm-1·W·Hz-1/2 with 30 GHz simultaneous spectral bandwidth. Importantly, the optomechanical resonator allows broadband dual-comb excitation. Our approach not only enriches the practical applications of the emerging cavity optomechanics technology but also offers intriguing possibilities for multi-species trace gas detection.

A sub-ppbv-level Acetone and Ethanol Quantum Cascade Laser Based Photoacoustic Sensor - Characterization and Multi-Component Spectra Recording in Synthetic Breath

Trace gas analysis in breath is challenging due to the vast number of different components. We present a highly sensitive quantum cascade laser based photoacoustic setup for breath analysis. Scanning the range between 8263 and 8270 nm with a spectral resolution of 48 pm, we are able to quantify acetone and ethanol within a typical breath matrix containing water and CO2. We photoacoustically acquired spectra within this region of mid-infra-red light and prove that those spectra do not suffer from non-spectral interferences. The purely additive behavior of a breath sample spectrum was verified by comparing it with the independently acquired single component spectra using Pearson and Spearman correlation coefficients. A previously presented simulation approach is improved and an error attribution study is presented. With a 3σ detection limit of 6.5 ppbv in terms of ethanol and 250 pptv regarding acetone, our system is among the best performing presented so far.

Antireflection microstructures fabricated on the surface of a LiGaSe2 nonlinear crystal

LiGaSe₂ is a propitious material for nonlinear parametric conversion in the mid-infrared (mid-IR) range. Its refractive index of n = 2.25 in the 2-12 µm wavelength range results in significant losses due to Fresnel reflection. However, the conventional method of increasing the transmittance with antireflection coatings (ARCs) significantly reduces the damage threshold of the material. Fabrication of the antireflection microstructures (ARMs) is an alternative approach for increasing the surface transmittance. In this work, ARMs were fabricated on the surface of a LiGaSe₂ crystal using a single-pulse femtosecond laser ablation method. An average transmittance of 97.2% in the 2-8 µm spectral range and the maximum transmittance of 98.6% at 4.1 µm were achieved.

Rapid Detection of Volatile Organic Compounds by Switch-Scan Tuning of Vernier Quantum-Cascade Lasers

Volatile organic compounds (VOCs) exhibit typically broad and mutually overlapping ro-vibrational absorption fingerprints. This complexity has so far limited the applicability of laser-based spectroscopy for VOC measurements in complex gas matrices. Here, we exploit a Vernier-type quantum-cascade laser (QCL) as an electrically tunable multiwavelength source for selective and sensitive VOC analysis. This emerging class of lasers provides access to several spectral windows by discrete Vernier tuning ("switching") and continuous coverage within these windows ("scanning"). We present a versatile driving technique that efficiently combines the two tuning mechanisms. Applied to our Vernier QCL, it enables the rapid acquisition (within 360 ms) of high-resolution spectra from six individual spectral windows, distributed over a wide range from 1063 to 1102 cm-1. Gaining access to the broad absorption envelopes of VOCs at multiple frequencies, along with their superimposed fine structure, which are especially pronounced at a reduced sample pressure, offers completely new opportunities in VOC analysis. The potential of this approach is assessed in a direct-laser-absorption setup with acetaldehyde, ethanol, and methanol as benchmark compounds with significant spectral overlaps. A measurement precision of 1-10 ppb is obtained after integration for 10 s at amount fractions below 10 ppm, and excellent linearity is found over at least 3 orders of magnitude. Combined with our dedicated spectral fitting algorithm, we demonstrate highly selective multicompound analyses with less than 3.5% relative expanded uncertainty, even in the presence of a 40× excess of an interfering compound with complete spectral overlap.

Compact laser spectroscopic sensor head prototype for time-resolved breath oxygen monitoring

A small and lightweight optical sensor head prototype with a disposable airway adapter for continuous mainstream monitoring of oxygen at high sampling rate is designed and tested on an optical benchtop. In terms of its size and functionality, the sensor head design is similar to current capnography systems from leading medical equipment manufacturers, and it has been designed within constraints of potential applications in direct breath oxygen monitoring that require direct interaction with the gas inside a breathing tube. The measurement precision of 0.1% O₂with a 10 ms integration time are well within the performance required for breath O₂monitoring applications.

Dual-comb quartz-enhanced photoacoustic spectroscopy

Photoacoustic spectroscopy (PAS) using two optical combs is a new-born technique, offering appealing features, including broad optical bandwidths, high resolutions, fast acquisition speeds, and wavelength-independent photoacoustic detection, for chemical sensing. However, its further application to, e.g., trace detection, is jeopardized due to the fundamentally and technically limited sensitivity and specificity. Here, we take a different route to comb-enabled PAS with acoustically enhanced sensitivity and nonlinear spectral hole-burning defined resolution. We demonstrate dual-comb quartz-enhanced PAS with two near-infrared electro-optic combs and a quartz tuning fork. Comb-line-resolved multiplexed spectra are acquired for acetylene with a single-pass detection limit at the parts-per-billion level. The technique is further extended to the mid-infrared (for methane), enabling improved sensitivity. More importantly, we measure nonlinear dual-comb photoacoustic spectra for the 12C2H2 ν1 + ν3 band P(17) transition with sub-Doppler pressure-broadening dominated homogeneous linewidths (e.g., 45.8 MHz), hence opening up new opportunities for Doppler-free photoacoustic gas sensing.

Mask assistance to colorimetric sniffers for detection of Covid-19 disease using exhaled breath metabolites

According to World Health Organization reports, large numbers of people around the globe have been infected or died for Covid-19 due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Researchers are still trying to find a rapid and accurate diagnostic method for revealing infected people by low viral load with the overriding goal of effective diagnostic management. Monitoring the body metabolic changes is known as an effective and inexpensive approach for the evaluation of the infected people. Here, an optical sniffer is introduced to detect exhaled breath metabolites of patients with Covid-19 (60 samples), healthy humans (55 samples), and cured people (15 samples), providing a unique color pattern for differentiation between the studied samples. The sniffer device is installed on a thin face mask, and directly exposed to the exhaled breath stream. The interactions occurring between the volatile compounds and sensing components such as porphyrazines, modified organic dyes, porphyrins, inorganic complexes, and gold nanoparticles allowing for the change of the color, thus being tracked as the sensor responses. The assay accuracy for the differentiation between patient, healthy and cured samples is calculated to be in the range of 80%-84%. The changes in the color of the sensor have a linear correlation with the disease severity and viral load evaluated by rRT-PCR method. Interestingly, comorbidities such as kidney, lung, and diabetes diseases as well as being a smoker may be diagnosed by the proposed method. As a powerful detection device, the breath sniffer can replace the conventional rapid test kits for medical applications.

Mask assistance to colorimetric sniffers for detection of Covid-19 disease using exhaled breath metabolites

According to World Health Organization reports, large numbers of people around the globe have been infected or died for Covid-19 due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Researchers are still trying to find a rapid and accurate diagnostic method for revealing infected people by low viral load with the overriding goal of effective diagnostic management. Monitoring the body metabolic changes is known as an effective and inexpensive approach for the evaluation of the infected people. Here, an optical sniffer is introduced to detect exhaled breath metabolites of patients with Covid-19 (60 samples), healthy humans (55 samples), and cured people (15 samples), providing a unique color pattern for differentiation between the studied samples. The sniffer device is installed on a thin face mask, and directly exposed to the exhaled breath stream. The interactions occurring between the volatile compounds and sensing components such as porphyrazines, modified organic dyes, porphyrins, inorganic complexes, and gold nanoparticles allowing for the change of the color, thus being tracked as the sensor responses. The assay accuracy for the differentiation between patient, healthy and cured samples is calculated to be in the range of 80%-84%. The changes in the color of the sensor have a linear correlation with the disease severity and viral load evaluated by rRT-PCR method. Interestingly, comorbidities such as kidney, lung, and diabetes diseases as well as being a smoker may be diagnosed by the proposed method. As a powerful detection device, the breath sniffer can replace the conventional rapid test kits for medical applications.

Tunable laser spectroscopy for carbon dioxide capnography and water vapor sensing inside a breathing mask: application to pilot life support

Tunable laser spectroscopy (TLS) near 2683 nm was used to measure carbon dioxide and water vapor inside a pilot mask during jet fighter flights. Measurement frequency was 100 Hz in order to capture breathing profiles and other gas flow dynamics. Analysis of the full inhalation and exhalation breathing cycle allowed precise monitoring of breathing performance and interaction of the pilot with the life-support system. Measurements revealed dynamic phenomena pertaining to mechanical gas flow and pilot respiration that may be used to understand gas delivery stresses imposed upon the pilot and pilot physiology during flight. Typically, such measurements are made with non-dispersive infrared (NDIR) instrumentation for only carbon dioxide with intrinsic challenges regarding time and optical resolution. The TLS approach is a major advance because the sensor is placed directly into the mask improving its time response and enabling use of water vapor measurements that are less impacted from memory effects. This article presents the implementation of TLS and shows highly time-resolved pilot breathing data for high-performance aircraft tests.

Acoustic, Phononic, Brillouin Light Scattering and Faraday Wave-Based Frequency Combs: Physical Foundations and Applications

Frequency combs (FCs)-spectra containing equidistant coherent peaks-have enabled researchers and engineers to measure the frequencies of complex signals with high precision, thereby revolutionising the areas of sensing, metrology and communications and also benefiting the fundamental science. Although mostly optical FCs have found widespread applications thus far, in general FCs can be generated using waves other than light. Here, we review and summarise recent achievements in the emergent field of acoustic frequency combs (AFCs), including phononic FCs and relevant acousto-optical, Brillouin light scattering and Faraday wave-based techniques that have enabled the development of phonon lasers, quantum computers and advanced vibration sensors. In particular, our discussion is centred around potential applications of AFCs in precision measurements in various physical, chemical and biological systems in conditions where using light, and hence optical FCs, faces technical and fundamental limitations, which is, for example, the case in underwater distance measurements and biomedical imaging applications. This review article will also be of interest to readers seeking a discussion of specific theoretical aspects of different classes of AFCs. To that end, we support the mainstream discussion by the results of our original analysis and numerical simulations that can be used to design the spectra of AFCs generated using oscillations of gas bubbles in liquids, vibrations of liquid drops and plasmonic enhancement of Brillouin light scattering in metal nanostructures. We also discuss the application of non-toxic room-temperature liquid-metal alloys in the field of AFC generation.

The need for multicomponent gas standards for breath biomarker analysis

Exhaled breath is a non-invasive, information-rich matrix with the potential to diagnose or monitor disease, including infectious disease. Despite significant effort dedicated to biomarker identification in case control studies, very few breath tests are established in practice. In this topical review, we identify how gas standards support breath analysis today and what is needed to support further expansion and translation to practice. We examine forensic and clinical breath tests and discuss how confidence has been built through unambiguous biomarker identification and quantitation supported by gas calibration standards. Based on this discussion, we identify a need for multicomponent gas standards with part-per-trillion to part-per-million concentrations. We highlight National Institute of Standards and Technology (NIST) gas standards developed for atmospheric measurements that are also relevant to breath analysis and describe investigations of long-term stability, chemical reactions, and interactions with gas cylinder wall treatments. An overview of emerging online instruments and their need for gas standards is also presented. This review concludes with a discussion of our ongoing research to examine the feasibility of producing multicomponent gas standards at breath-relevant concentrations. Such standards could be used to investigate interference from ubiquitous endogenous compounds and as a starting point for standards tailored to specific breath tests.

Optical frequency comb Fourier transform cavity ring-down spectroscopy

We demonstrate broadband and sensitive cavity ring-down spectroscopy using a near infrared frequency comb and a time-resolved Fourier transform spectrometer. The cavity decays are measured simultaneously at each optical path difference and spectrally sorted, leading to purely exponential decays for each spectral element. The absorption spectra of atmospheric water and carbon dioxide are retrieved and demonstrate the high frequency resolution and absorption precision of the technique. The experimental apparatus, the measurement concept and the data treatment are described. The technique benefits from the advantages of cavity ring-down spectroscopy, i.e. the retrieved absorption does not depend on the cavity parameters, opening up for high accuracy absorption spectroscopy entirely calibration-free.

Detection of volatile organic compounds using mid-infrared silicon nitride waveguide sensors

Mid-infrared (mid-IR) sensors consisting of silicon nitride (SiN) waveguides were designed and tested to detect volatile organic compounds (VOCs). SiN thin films, prepared by low-pressure chemical vapor deposition (LPCVD), have a broad mid-IR transparent region and a lower refractive index (n_SiN = 2.0) than conventional materials such as Si (n_Si = 3.4), which leads to a stronger evanescent wave and therefore higher sensitivity, as confirmed by a finite-difference eigenmode (FDE) calculation. Further, in-situ monitoring of three VOCs (acetone, ethanol, and isoprene) was experimentally demonstrated through characteristic absorption measurements at wavelengths λ = 3.0–3.6 μm. The SiN waveguide showed a five-fold sensitivity improvement over the Si waveguide due to its stronger evanescent field. To our knowledge, this is the first time SiN waveguides are used to perform on-chip mid-IR spectral measurements for VOC detection. Thus, the developed waveguide sensor has the potential to be used as a compact device module capable of monitoring multiple gaseous analytes for health, agricultural and environmental applications.

Infrared cavity ring-down spectroscopy for detecting non-small cell lung cancer in exhaled breath

Early diagnosis of lung cancer greatly improves the likelihood of survival and remission, but limitations in existing technologies like low-dose computed tomography have prevented the implementation of widespread screening programs. Breath-based solutions that seek disease biomarkers in exhaled volatile organic compound (VOC) profiles show promise as affordable, accessible and non-invasive alternatives to traditional imaging. In this pilot work, we present a lung cancer detection framework using cavity ring-down spectroscopy (CRDS), an effective and practical laser absorption spectroscopy technique that has the ability to advance breath screening into clinical reality. The main aims of this work were to 1) test the utility of infrared CRDS breath profiles for discriminating non-small cell lung cancer (NSCLC) patients from controls, 2) compare models with VOCs as predictors to those with patterns from the CRDS spectra (breathprints) as predictors, and 3) present a robust approach for identifying relevant disease biomarkers. First, based on a proposed learning curve technique that estimated the limits of a model's performance at multiple sample sizes (10-158), the CRDS-based models developed in this work were found to achieve classification performance comparable or superior to like mass spectroscopy and sensor-based systems. Second, using 158 collected samples (62 NSCLC subjects and 96 controls), the accuracy range for the VOC-based model was 65.19%-85.44% (51.61%-66.13% sensitivity and 73.96%-97.92% specificity), depending on the employed cross-validation technique. The model based on breathprint predictors generally performed better, with accuracy ranging from 71.52%-86.08% (58.06%-82.26% sensitivity and 80.21%-88.54% specificity). Lastly, using a protocol based on consensus feature selection, three VOCs (isopropanol, dimethyl sulfide, and butyric acid) and two breathprint features (from a local binary pattern transformation of the spectra) were identified as possible NSCLC biomarkers. This research demonstrates the potential of infrared CRDS breath profiles and the developed early-stage classification techniques for NSCLC biomarker detection and screening.

Simultaneous Sensitive Determination of δ13C, δ18O, and δ17O in Human Breath CO2 Based on ICL Direct Absorption Spectroscopy

Previous research revealed that isotopes ¹³C and ¹⁸O of exhaled CO₂ have the potential link with Helicobacter pylori; however, the ¹⁷O isotope has received very little attention. We developed a sensitive spectroscopic sensor for simultaneous δ¹³C, δ¹⁸O, and δ¹⁷O analysis of human breath CO₂ based on mid-infrared laser direct absorption spectroscopy with an interband cascade laser (ICL) at 4.33 μm. There was a gas cell with a small volume of less than 5 mL, and the pressure in the gas cell was precisely controlled with a standard deviation of 0.0035 Torr. Moreover, real-time breath sampling and batch operation were achieved in gas inlets. The theoretical drifts for δ¹³C, δ¹⁸O, and δ¹⁷O measurement caused by temperature were minimized to 0.017‰, 0.024‰, and 0.021‰, respectively, thanks to the precise temperature control with a standard deviation of 0.0013 °C. After absolute temperature correction, the error between the system responded δ-value and the reference is less than 0.3‰. According to Allan variance analysis, the system precisions for δ¹³C, δ¹⁸O, and δ¹⁷O were 0.12‰, 0.18‰, and 0.47‰, respectively, at 1 s integration time, which were close to the real-time measurement errors of six repeated exhalations.

Dual-comb cavity ring-down spectroscopy

Cavity ring-down spectroscopy is a ubiquitous optical method used to study light-matter interactions with high resolution, sensitivity and accuracy. However, it has never been performed with the multiplexing advantages of direct frequency comb spectroscopy without significantly compromising spectral resolution. We present dual-comb cavity ring-down spectroscopy (DC-CRDS) based on the parallel heterodyne detection of ring-down signals with a local oscillator comb to yield absorption and dispersion spectra. These spectra are obtained from widths and positions of cavity modes. We present two approaches which leverage the dynamic cavity response to coherently or randomly driven changes in the amplitude or frequency of the probe field. Both techniques yield accurate spectra of methane-an important greenhouse gas and breath biomarker. When combined with broadband frequency combs, the high sensitivity, spectral resolution and accuracy of our DC-CRDS technique shows promise for applications like studies of the structure and dynamics of large molecules, multispecies trace gas detection and isotopic composition.

Data Pre-Processing of Infrared Spectral Breathprints for Lung Cancer Detection

Though breath analysis shows promise as a noninvasive and cost-effective approach to lung cancer screening, biomarkers in exhaled breath samples can be overwhelmed by irrelevant internal and environmental volatile organic compounds (VOCs). These extraneous VOCs can obscure the disease signature in a spectral breathprint, hindering the performance of pattern recognition models. In this work, pre-processing pipelines consisting of missing value replacement, detrending, and normalization techniques were evaluated to reduce these effects and enhance the features of interest in infrared cavity ring-down spectra. The best performing pipeline consisted of moving average detrending, linear interpolation for missing values, and vector normalization. This model achieved an average accuracy of 73.04% across five types of classifiers, exhibiting an 8.36% improvement compared to a baseline model (p < 0.05). A linear support vector machine classifier yielded the best performance (79.75% accuracy, 67.74% sensitivity, 87.50% specificity). This work can serve to guide pre-processing in future lung cancer breath research and, more broadly, in infrared laser absorption spectroscopy in general.

Study of a Mode Separation Due to Polarization Existing in a Cavity-Enhanced Absorption Spectroscopy

A special phenomenon of resonance mode separation is observed during the study of a high sensitivity folded-cavity enhanced absorption spectroscopy for the measurement of trace gases. The phenomenon affects the measurement of gas absorption spectrum in the cavity. This resonant mode separation phenomenon of the resonant cavity is different from the resonant modes previously observed in linear-cavity enhanced absorption spectroscopy systems. To explore the mechanism of this phenomenon, a series of hypotheses are proposed. The most likely reason among these hypotheses is based on the different reflectance properties of the plane mirror at the fold of the cavity for S-polarized light and P-polarized light. Based on the matrix calculation method, the different reflectance and phase shift of the plane mirror for S-polarized light and P-polarized light are analyzed theoretically, and the results are in better agreement with the phenomena observed in the experiment. Finally, in order to eliminate the resonant mode separation phenomenon, line polarizers were added. By improving the system, the cavity enhanced absorption spectrum of residual water vapor in the cavity was successfully measured, and a minimum detectable absorption coefficient of α_min = 7.6 × 10⁻⁹ cm⁻¹ can be obtained in a single laser scan of 10 s.

Ultrasensitive multispecies spectroscopic breath analysis for real-time health monitoring and diagnostics

Breath analysis enables rapid, noninvasive diagnostics, as well as long-term monitoring of human health, through the identification and quantification of exhaled biomarkers. Here, we demonstrate the remarkable capabilities of mid-infrared (mid-IR) cavity-enhanced direct-frequency comb spectroscopy (CE-DFCS) applied to breath analysis. We simultaneously detect and monitor as a function of time four breath biomarkers-[Formula: see text]OH, [Formula: see text], [Formula: see text]O, and HDO-as well as illustrate the feasibility of detecting at least six more ([Formula: see text]CO, [Formula: see text], OCS, [Formula: see text], [Formula: see text], and [Formula: see text]) without modifications to the experimental apparatus. We achieve ultrahigh detection sensitivity at the parts-per-trillion level. This is made possible by the combination of the broadband spectral coverage of a frequency comb, the high spectral resolution afforded by the individual comb teeth, and the sensitivity enhancement resulting from a high-finesse cavity. Exploiting recent advances in frequency comb, optical coating, and photodetector technologies, we can access a large variety of biomarkers with strong carbon-hydrogen-bond spectral signatures in the mid-IR.

Robust, fast and sensitive near-infrared continuous-filtering Vernier spectrometer

We present a new design of a robust cavity-enhanced frequency comb-based spectrometer operating under the continuous-filtering Vernier principle. The spectrometer is based on a compact femtosecond Er-doped fiber laser, a medium finesse cavity, a diffraction grating, a custom-made moving aperture, and two photodetectors. The new design removes the requirement for high-bandwidth active stabilization present in the previous implementations of the technique, and allows scan rates up to 100 Hz. We demonstrate the spectrometer performance over a wide spectral range by detecting CO₂ around 1575 nm (1.7 THz bandwidth and 6 GHz resolution) and CH₄ around 1650 nm (2.7 THz bandwidth and 13 GHz resolution). We achieve absorption sensitivity of 5 × 10^-9 cm^-1 Hz^-1/2 at 1575 nm, and 1 × 10^-7 cm^-1 Hz^-1/2 cm^-1 at 1650 nm. We discuss the influence of the scanning speed above the adiabatic limit on the amplitude of the absorption signal.

Towards an Optical Gas Standard for Traceable Calibration-Free and Direct NO2 Concentration Measurements

We report a direct tunable diode laser absorption spectroscopy (dTDLAS) instrument developed for NO2 concentration measurements without chemical pre-conversion, operated as an Optical Gas Standard (OGS). An OGS is a dTDLAS instrument that can deliver gas species amount fractions (concentrations), without any previous or routine calibration, which are directly traceable to the international system of units (SI). Here, we report NO2 amount fraction quantification in the range of 100–1000 µmol/mol to demonstrate the current capability of the instrument as an OGS for car exhaust gas application. Nitrogen dioxide amount fraction results delivered by the instrument are in good agreement with certified values of reference gas mixtures, validating the capability of the dTDLAS-OGS for calibration-free NO2 measurements. As opposed to the standard reference method (SRM) based on chemiluminescence detection (CLD) where NO2 is indirectly measured after conversion to NO, titration with O3 and the detection of the resulting fluorescence, a dTDLAS-OGS instrument has the benefit of directly measuring NO2 without distorting or delaying conversion processes. Therefore, it complements the SRM and can perform fast and traceable measurements, and side-by-side calibrations of other NO2 gas analyzers operating in the field. The relative standard uncertainty of the NO2 results reported in this paper is 5.1% (k = 1, which is dominated (98%) by the NO2 line strength), the repeatability of the results at 982.6 µmol/mol is 0.1%, the response time of the instrument is 0.5 s, and the detection limit is 825 nmol/mol at a time resolution of 86 s.

High speed external cavity diode laser concept based on a resonantly driven MEMS scanner for the mid-infrared region

The rapid detection of trace gases is of great relevance for various spectroscopy applications. In this regard, the technology of external cavity diode lasers (ECDLs) has firmly established itself due to its excellent properties. Outside of the laboratory environment, however, these still have some restrictions, especially with regard to high acquisition rates for sensitive spectroscopy applications and mode-hop-free tuning. In this article, we present our innovative GaSb-based ECDL concept, in which a resonantly driven microelectromechanical system actuator is used. With this, a defined frequency range can be tuned extremely fast and without mode hops. Results of the characterization and its use for the rapid detection of trace gases are presented.

QEPAS sensor in a butterfly package and its application

Molecular gases are highly relevant in healthcare, production control, safety, and environmental monitoring. They often appear in small concentrations. The measurement of trace gases has increasingly become a key technique in those domains. Quartz-enhanced photoacoustic spectroscopy (QEPAS) is a suitable method that can provide the required low detection limits in such applications at comparatively low cost and small size. For mobile implementation, the size of an entire sensor unit matters. In this paper, we present a QEPAS sensor that fits into a standard butterfly package, its characterization, and its application on CH₄ and CO₂.

ZENose (ZIF-Based Electrochemical Nose) Platform for Noninvasive Ammonia Detection

Breathomics is a widely emerging tool for noninvasive disease diagnosis and focuses on the detection of various levels of volatile organic compounds and inorganic gases present in human breath. One of the rapid, easy-to-use, and noninvasive detection methods being investigated is a system that can measure exhaled breath ammonia levels and can be correlated to the functional state of protein metabolic pathways and the renal functioning system. In this work, we have demonstrated the development of an electrochemical nose system using ferrocene encapsulated into zeolitic imidazole framework, Fc@ZIF-8, which can be successfully used for the detection of ammonia levels in breath. This is the first report of an electrochemical gas sensor platform that uses a faradaic probe (that is ferrocene) encapsulated into a metal-organic framework cavity used for disease diagnosis by monitoring the levels of the target gas and can be used for breathomics applications. This work demonstrates that low levels of ammonia gas (up to 400 ppb) can be detected with high sensitivity and specificity. The morphological and structural characterization of the novel, synthesized Fc@ZIF-8 nanocomposite has been performed using powder X-ray diffraction, field emission scanning electron microscopy, Fourier transform infrared, ultraviolet-visible spectroscopy, and dynamic light scattering. Electrochemical characterization of the material has been performed using a standard glassy carbon electrode, and further application of the material has been shown using the in-house designed and reported spiral electrochemical notification coupled electrode, used for ammonia gas sensing. Cross-reactivity studies have also been performed to demonstrate sensor specificity toward the target gas. We demonstrate the first of its kind electrochemical bifunctional probe platform that can be used for sensing ammonia levels in breath, with high sensitivity and specificity, due to the hybrid material system-zinc-imidazole framework 8 (having excellent physisorption properties) and ferrocene (acting as a redox mediator). We envision that such a sensing system will allow noninvasive and early diagnosis of chronic kidney disease, thus leading to early treatment and a decrease in the mortality rate.

Room-temperature Fe:ZnSe laser tunable in the spectral range of 3.7-5.3 µm applied for intracavity absorption spectroscopy of CO2 isotopes, CO and N2O

We demonstrate an intracavity absorption spectroscopy system based on a broadband single-crystal pulsed Fe:ZnSe laser. The laser operates at room-temperature and is continuously tunable in the spectral range of 3.76-5.29 µm. The long-wavelength emission up to 5.29 µm is a record achievement for Fe:ZnSe lasers, to the best of our knowledge. The developed laser system is applied for measurements of gaseous absorption inside the laser resonator. We demonstrate sensitive detection of (i) CO₂ isotopes in the atmosphere and in human breath, (ii) CO in breath (after cigarette smoking) and in the smoke of a smoldering paper, and (iii) N₂O in a gas flow. The achieved detection limits are: 0.1 ppm for ¹²CO₂ and ¹³CO₂, 3 ppm for CO, and 1 ppm for N₂O. The sensitivity of the current system is primarily limited by the short pump-pulse duration of 40 ns. Possibilities for sensitivity enhancement by up to a factor of 10⁷ are discussed.

Application of machine learning and laser optical-acoustic spectroscopy to study the profile of exhaled air volatile markers of acute myocardial infarction

Conventional acute myocardial infarction (AMI) diagnosis is quite accurate and has proved its effectiveness. However, despite this, discovering more operative methods of this disease detection is underway. From this point of view, the application of exhaled air analysis for a similar diagnosis is valuable. The aim of the paper is to research effective machine learning algorithms for the predictive model for AMI diagnosis constructing, using exhaled air spectral data. The target group included 30 patients with primary myocardial infarction. The control group included 42 healthy volunteers. The 'LaserBreeze' laser gas analyzer (Special Technologies Ltd, Russia), based on the dual-channel resonant photoacoustic detector cell and optical parametric oscillator as the laser source, had been used. The pattern recognition approach was applied in the same manner for the set of extracted concentrations of AMI volatile markers and the set of absorption coefficients in a most informative spectral range 2.900 ± 0.125µm. The created predictive model based on the set of absorption coefficients provided 0.86 of the mean values of both the sensitivity and specificity when linear support vector machine (SVM) combined with principal component analysis was used. The created predictive model based on using six volatile AMI markers (C₅H₁₂, N₂O, NO₂, C₂H₄, CO, CO₂) provided 0.82 and 0.93 of the mean values of the sensitivity and specificity, respectively, when linear SVM was used.

Surface Functionalization Utilizing Mesoporous Silica Nanoparticles for Enhanced Evanescent-Field Mid-Infrared Waveguide Gas Sensing

This work focuses on the development of nanoparticle-based layer-by-layer (LbL) coatings for enhancing the detection sensitivity and selectivity of volatile organic compounds (VOCs) using on-chip mid-infrared (MIR) waveguides (WGs). First, we demonstrate construction of conformal coatings of polymer/mesoporous silica nanoparticles (MSNs) on the surface of Si-based WGs using the LbL technique and evaluate the coating deposition conditions, such as pH and substrate withdrawal speed, on the thickness and homogeneity of the assemblies. We then use the modified WGs to achieve enhanced sensitivity and selectivity of polar organic compounds, such as ethanol, versus non-polar ones, such as methane, in the MIR region. In addition, using density functional theory calculations, we show that such an improvement in sensing performance is achieved due to preferential adsorption of ethanol molecules within MSNs in the vicinity of the WG evanescent field.

Monitoring of endogenous nitric oxide exhaled by pig lungs during ex-vivo lung perfusion

In the context of organ shortage for transplantation, new criteria for better organ evaluation should be investigated. Ex-Vivo Lung Perfusion (EVLP) allows extra-corporal lung re-conditioning and evaluation, under controlled parameters of the organ reperfusion and mechanical ventilation. This work reports on the interest of exhaled gas analysis during the EVLP procedure. After a one-hour cold ischemia, the endogenous gas production by an isolated lung of nitric oxide and carbon monoxide is simultaneously monitored in real time. The exhaled gas is analysed with two very sensitive and selective laser spectrometers developed upon the technique of optical-feedback cavity-enhanced absorption spectroscopy. Exhaled gas concentration measured for an ex-vivo lung is compared to the corresponding production by the whole living pig, measured before euthanasia. On-line measurements of the fraction of nitric oxide in exhaled gas (FENO) in isolated lungs are reported here for the first time, allowing to resolve the respiratory cycles. In this study, performed on 9 animals, FENO by isolated lungs range from 3.3 to 10.6 ppb with a median value of 4.4 ppb. Pairing ex-vivo lung and pig measurements allows to demonstrate a systematic increase of FENO in the ex-vivo lung as compared to the living animal, by a factor of 3 ± 1.2. Measurements of the fraction of carbon monoxide in exhaled gas (FECO) confirm levels recorded during previous studies driven to evaluate FECO as a potential marker of ischemia reperfusion injuries. FECO production by ex-vivo lungs ranges from 0.31 to 2.3 ppm with a median value of 0.8 ppm. As expected, these FECO values are lower than the production by the corresponding whole pig body, by a factor of 6.9 ± 2.7.

Interband Cascade Photonic Integrated Circuits on Native III-V Chip

We describe how a midwave infrared photonic integrated circuit (PIC) that combines lasers, detectors, passive waveguides, and other optical elements may be constructed on the native GaSb substrate of an interband cascade laser (ICL) structure. The active and passive building blocks may be used, for example, to fabricate an on-chip chemical detection system with a passive sensing waveguide that evanescently couples to an ambient sample gas. A variety of highly compact architectures are described, some of which incorporate both the sensing waveguide and detector into a laser cavity defined by two high-reflectivity cleaved facets. We also describe an edge-emitting laser configuration that optimizes stability by minimizing parasitic feedback from external optical elements, and which can potentially operate with lower drive power than any mid-IR laser now available. While ICL-based PICs processed on GaSb serve to illustrate the various configurations, many of the proposed concepts apply equally to quantum-cascade-laser (QCL)-based PICs processed on InP, and PICs that integrate III-V lasers and detectors on silicon. With mature processing, it should become possible to mass-produce hundreds of individual PICs on the same chip which, when singulated, will realize chemical sensing by an extremely compact and inexpensive package.

Vacuum Ultraviolet Absorption Spectroscopy Analysis of Breath Acetone Using a Hollow Optical Fiber Gas Cell

Human breath is a biomarker of body fat metabolism and can be used to diagnose various diseases, such as diabetes. As such, in this paper, a vacuum ultraviolet (VUV) spectroscopy system is proposed to measure the acetone in exhaled human breath. A strong absorption acetone peak at 195 nm is detected using a simple system consisting of a deuterium lamp source, a hollow-core fiber gas cell, and a fiber-coupled compact spectrometer corresponding to the VUV region. The hollow-core fiber functions both as a long-path and an extremely small-volume gas cell; it enables us to sensitively measure the trace components of exhaled breath. For breath analysis, we apply multiple regression analysis using the absorption spectra of oxygen, water, and acetone standard gas as explanatory variables to quantitate the concentration of acetone in breath. Based on human breath, we apply the standard addition method to obtain the measurement accuracy. The results suggest that the standard deviation is 0.074 ppm for healthy human breath with an acetone concentration of around 0.8 ppm and a precision of 0.026 ppm. We also monitor body fat burn based on breath acetone and confirm that breath acetone increases after exercise because it is a volatile byproduct of lipolysis.

Stretchable gas sensors for detecting biomarkers from humans and exposed environments

The recent advent of stretchable gas sensors demonstrates their capabilities to detect not only gaseous biomarkers from the human body but also toxic gas species from the exposed environment. To ensure accurate gas detection without device breakdown from the mechanical deformations, the stretchable gas sensors often rely on the direct integration of gas-sensitive nanomaterials on the stretchable substrate or fibrous network, as well as being configured into stretchable structures. The nanomaterials in the forms of nanoparticles, nanowires, or thin-films with nanometer thickness are explored for a variety of sensing materials. The commonly used stretchable structures in the stretchable gas sensors include wrinkled structures from a pre-strain strategy, island-bridge layouts or serpentine interconnects, strain isolation approaches, and their combinations. This review aims to summarize the recent advancement in novel nanomaterials, sensor design innovations, and new fabrication approaches of stretchable gas sensors.

A Review of Methods to Determine Viability, Vitality, and Metabolic Rates in Microbiology

Viability and metabolic assays are commonly used as proxies to assess the overall metabolism of microorganisms. The variety of these assays combined with little information provided by some assay kits or online protocols often leads to mistakes or poor interpretation of the results. In addition, the use of some of these assays is restricted to simple systems (mostly pure cultures), and care must be taken in their application to environmental samples. In this review, the necessary data are compiled to understand the reactions or measurements performed in many of the assays commonly used in various aspects of microbiology. Also, their relationships to each other, as metabolism links many of these assays, resulting in correlations between measured values and parameters, are discussed. Finally, the limitations of these assays are discussed.

Selective detection of complex gas mixtures using point contacts: concept, method and tools

Of all modern nanosensors using the principle of measuring variations in electric conductance, point-contact sensors stand out in having a number of original sensor properties not manifested by their analogues. The nontrivial nature of point-contact sensors is based on the unique properties of Yanson point contacts used as the sensing elements. The quantum properties of Yanson point contacts enable the solution of some of the problems that could not be solved using conventional sensors measuring conductance. In the present paper, we demonstrate this by showing the potential of quantum point-contact sensors to selectively detect components of a gas mixture in real time. To demonstrate the high efficiency of the proposed approach, we analyze the human breath, which is the most complex of the currently known natural gas mixtures with extremely low concentrations of its components. Point-contact sensors allow us to obtain a spectroscopic profile of the mixture. This profile contains information about the complete set of energy interactions occurring in the point contact/breath system when the breath constituents adsorb to and desorb from the surface of the point-contact conduction channel. With this information we can unambiguously characterize the analyzed system, since knowing the energy parameters is key to successfully identifying and modeling the physicochemical properties of various quantum objects. Using the point-contact spectroscopic profile of a complex gas mixture it is possible to get a functional dependence of the concentration of particular breath components on the amplitude of the sensor output signal. To demonstrate the feasibility of the proposed approach, we analyze the point-contact profiles from the breath of several patients and compare them with the concentrations of serotonin and cortisol in the body of each patient. The obtained results demonstrate that the proposed methodology allows one to get an effective calibration function for a non-invasive analysis of the level of serotonin and cortisol in the human body using the point-contact breath test. The present study indicates some necessary prerequisites for the design of fast detection methods using differential sensor analysis in real time, which can be implemented in various areas of science and technology, among which medicine is one of the most important.

Impact of breath sampling on exhaled carbon monoxide

The influence of breath sampling on exhaled carbon monoxide (eCO) and related pulmonary gas exchange parameters is investigated in a study with 32 healthy non-smokers. Mid-infrared tunable diode laser absorption spectroscopy and well-controlled online sampling is used to precisely measure mouth- and nose-exhaled CO expirograms at exhalation flow rates (EFRs) of 250, 120 and 60 ml s^-1, and for 10 s of breath-holding followed by exhalation at 120 ml s^-1. A trumpet model with axial diffusion is employed to fit simulated exhalation profiles to the experimental expirograms, which provides equilibrium airway and alveolar CO concentrations and the average lung diffusing capacity in addition to end-tidal concentrations. For all breathing maneuvers, excellent agreement is found between mouth- and nose-exhaled end-tidal CO (ETCO), and the individual values for ETCO and alveolar diffusing capacity are consistent across maneuvers. The eCO parameters clearly show a dependence on EFR, where the lung diffusing capacity increases with EFR, while ETCO slightly decreases. End-tidal CO is largely independent of ambient air CO and alveolar diffusing capacity. While airway CO is slightly higher than, and correlates strongly with, ambient air CO, and there is a weak correlation with ETCO, the results point to negligible endogenous airway CO production in healthy subjects. An EFR of around 120 ml s^-1 can be recommended for clinical eCO measurements. The employed method provides means to measure variations in endogenous CO, which can improve the interpretation of exhaled CO concentrations and the diagnostic value of eCO tests in clinical studies. Clinical trial registration number: 2017/306-31.

Exhaled breath analysis using cavity-enhanced optical techniques: a review

Cavity-enhanced absorption spectroscopies (CEAS) have gained importance in a wide range of applications in molecular spectroscopy. The development of optical sensors based on the CEAS techniques coupled with the continuous wave or pulsed laser sources operating in the mid-infrared or near-infrared spectral regime uniquely offers molecularly selective and ultra-sensitive detection of trace species in complex matrices including exhaled human breath. In this review, we discussed recent applications of CEAS for analyzing trace constituents within the exhaled breath matrix facilitating the non-invasive assessment of human health status. Next to a brief discussion on the mechanisms of formation of trace components found in the exhaled breath matrix related to particular disease states, existing challenges in CEAS and future development towards non-invasive clinical diagnostics will be discussed.