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Cui Y, Ai S, Liu Y, Qian ZM, Wang C, Sun J, Sun X, Zhang S, Syberg KM, Howard S, Qin L, Lin H. Hourly associations between ambient temperature and emergency ambulance calls in one central Chinese city: Call for an immediate emergency plan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 711:135046. [PMID: 31812379 DOI: 10.1016/j.scitotenv.2019.135046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Most studies examining the short-term effects of temperature on health were based on the daily scale, few were at the hourly level. Revealing the relationship between unfavorable temperatures on an hourly basis and health is conducive to the development of more accurate extreme temperature early warning systems and reasonable dispatch of ambulances. METHODS Hourly data on temperature, air pollution (including PM2.5, O3, SO2 and NO2) and emergency ambulance calls (EACs) for all-cause, cardiovascular and respiratory diseases from January 16, 2014 to December 31, 2016 were obtained from Luoyang, China. A distributed lag non-linear model (DLNM) was used to assess the association between hourly temperature and ambulance calls after adjusting for potential confounding factors. The fractions of EACs attributable to non-optimum temperatures were also estimated. RESULTS Hourly temperature was associated with increased ambulance calls with a varying lag pattern. Extreme hot temperature (>32.1 °C) was positively associated with all-cause, cardiovascular diseases at lag 0-30 h and lag 0-9 h, while no significant effects were found for respiratory morbidity. Extreme cold temperature (<-2.5 °C) was positively associated with all-cause, cardiovascular and respiratory morbidity at lag 56-157 h, 50-145 h and 123-170 h. An overall EACs fraction of 6.84% [Backward estimate, 95% confidence interval (CI): 5.01%, 8.59%] could be attributed to non-optimum temperatures, and more contributions were caused by cold [Backward estimate: 6.06% (95% CI: 5.10%, 8.48%)] than by heat [Backward estimate: 0.79% (95% CI: 0.12%, 1.45%)]. CONCLUSIONS Extreme hot temperature may lead to increased ambulance calls within a few hours, while extreme cold temperature may not increase ambulance calls until more than 2 days later. Effective measures, such as forming hourly temperature warning standards, optimizing ambulance services at extreme temperatures, etc., should be taken to reduce the unfavorable temperature - associated EACs burden.
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Affiliation(s)
- Yingjie Cui
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Siqi Ai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuying Liu
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhengmin Min Qian
- Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Jia Sun
- Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Xiangyan Sun
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Kevin M Syberg
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Steven Howard
- Department of Health Management & Policy, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Dynamics of exhaled breath temperature after smoking a cigarette and its association with lung function changes predictive of COPD risk in smokers: a cross-sectional study. Arh Hig Rada Toksikol 2019; 70:123-129. [PMID: 31246566 DOI: 10.2478/aiht-2019-70-3211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 05/01/2019] [Indexed: 12/26/2022] Open
Abstract
Exhaled breath temperature (EBT) is a biomarker of inflammation and vascularity of the airways already shown to predict incident COPD. This cross-sectional study was aimed to assess the potential of EBT in identifying "healthy" smokers susceptible to cigarette smoke toxicity of the airways and to the risk of developing COPD by analysing the dynamics of EBT after smoking a cigarette and its associations with their demographics (age, smoking burden) and lung function. The study included 55 current smokers of both sexes, 29-62 years of age, with median smoking exposure of 15 (10-71.8) pack-years. EBT was measured at baseline and 5, 15, 30, 45, and 60 min after smoking a single cigarette. Lung function was measured with spirometry followed by a bronchodilator test. To compare changes in EBT between repeated measurements we used the analysis of variance and the area under the curve (EBTAUC) as a dependent variable. Multivariate regression analysis was used to look for associations with patient characteristics and lung function in particular. The average (±SD) baseline EBT was 33.42±1.50 °C. The highest significant increase to 33.84 (1.25) °C was recorded 5 min after the cigarette was smoked (p=0.003), and it took one hour for it to return to the baseline. EBTAUC showed significant repeatability (ICC=0.85, p<0.001) and was significantly associated with age, body mass index, number of cigarettes smoked a day, baseline EBT, and baseline FEF75 (R2=0.39, p<0.001 for the model). Our results suggest that EBT after smoking a single cigarette could be used as early risk predictor of changes associated with chronic cigarette smoke exposure.
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Carpagnano GE, Radaeli A, Lacedonia D, Correale M, Carpagnano G, Palmiotti A, Barbaro MPF, Di Biase M, Brunetti N, Scioscia G, Malerba M. Exhaled Nitric Oxide and Exhaled Breath Temperature as Potential Biomarkers in Patients with Pulmonary Hypertension. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7292045. [PMID: 30225263 PMCID: PMC6129334 DOI: 10.1155/2018/7292045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/06/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is a progressive fatal disease thus, noninvasive prognostic tools are needed to follow these patients. The aim of our study was to evaluate fractional exhaled nitric oxide (FeNO) and exhaled breath temperature (EBT) values in patients with PH from different causes and to correlate them with respiratory functional data. METHODS Twenty-four PH patients underwent spirometry, carbon monoxide diffusion (DLCO) test, transthoracic echocardiography, right-heart catheterization, and FeNO and EBT measurements. RESULTS We studied 3 groups according to the type of PH: 10 patients with pulmonary arterial hypertension (PAH) (group A), 11 patients with PH due to chronic obstructive pulmonary disease (COPD) (group B), and 3 patients with PH associated with left heart disease (group C). Mean FeNO values tend to be higher in group B (15.0 ± 9.3ppb) compared with other groups (respectively, 9.9 ± 5.7 and 8.5 ± 5.2 ppb in groups A and C; p = 0.271) but no statistical significance has been reached. Mean values of alveolar NO concentration (CANO) were higher in groups A and B compared to group C (respectively, 16.9 ± 12.6; 13.9 ± 6.8; and 6.7 ± 2.0 ppb) (p = 0.045). EBT mean values were significantly lower in group C when compared with other groups (group C: 29.0 +- 1.3°C, groups A and B: 30.9 ± 1.3 and 31.2 ± 1.2°C, respectively: p = 0.041). EBT levels were inversely correlated to mean pulmonary artery pressure (PAPm) levels (Spearman coefficient -0.481; p = 0.017). CONCLUSIONS eNO, CANO, and EBT have been evaluated in three groups of PH patients. Interestingly EBT reduction was correlated with PAPm increase, whereas FeNO was higher in COPD patients and CANO in PAH and COPD groups. Further studies are needed to clarify EBT, FeNO, and CANO roles as biomarkers in the monitoring of patients with PH.
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Affiliation(s)
- Giovanna Elisiana Carpagnano
- Sezione di Malattie dell'Apparato Respiratorio, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Alessandro Radaeli
- Dipartimento di Emergenza Urgenza, Spedali Civili di Brescia, Brescia, Italy
| | - Donato Lacedonia
- Sezione di Malattie dell'Apparato Respiratorio, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Michele Correale
- Cardiologia Universitaria, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Giuseppe Carpagnano
- Cardiologia Universitaria, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Antonio Palmiotti
- Cardiologia Universitaria, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Maria Pia Foschino Barbaro
- Sezione di Malattie dell'Apparato Respiratorio, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Matteo Di Biase
- Cardiologia Universitaria, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Natale Brunetti
- Cardiologia Universitaria, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Giulia Scioscia
- Sezione di Malattie dell'Apparato Respiratorio, Dipartimento di Scienze Mediche e Chirurgiche, Universita' di Foggia, Foggia, Italy
| | - Mario Malerba
- Malattie dell'Apparato Respiratorio, Dipartimento di Medicina Traslazionale, Università del Piemonte Orientale, Novara, Italy
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Popov TA, Kralimarkova TZ, Labor M, Plavec D. The added value of exhaled breath temperature in respiratory medicine. J Breath Res 2017; 11:034001. [PMID: 28592704 DOI: 10.1088/1752-7163/aa7801] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Recognition of the huge economic burden chronic respiratory diseases pose for society motivated fundamental and clinical research leading to insight into the role of airway inflammation in various disease entities and their phenotypes. However, no easy, cheap and patient-friendly methods to assess it have found a place in routine clinical practice. Measurement of exhaled breath temperature (EBT) has been suggested as a non-invasive method to detect inflammatory processes in the airways as a result of increased blood flow within the airway walls. As EBT values are within a narrow range, the thermometers designed for the purpose of assessing it need to be precise and very sensitive. EBT increases linearly over the pediatric age range and seems to be influenced by gender, but not by height and body weight. In non-smoking individuals with no history of respiratory disease EBT has a natural circadian peak about noon and increases with food intake and physical exercise. When interpreting EBT in subjects with alleged airway pathology, the possibilities of tissue destruction (chronic obstructive pulmonary disease, cystic fibrosis) or excessive bronchial obstruction and air trapping (severe asthma) need to be considered, as these conditions drive (force) EBT down. A prominent advantage of the method is to assess EBT when patients are in a steady state of their disease and to use this 'personal best' to monitor them and guide their treatment. Individual devices outfitted with microprocessors and memory have been created, which can be used for personalized monitoring and disease management by telemedicine.
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Affiliation(s)
- Todor A Popov
- Clinic of Allergy and Asthma, Medical University Sofia, Bulgaria
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Labor M, Vrbica Ž, Gudelj I, Labor S, Jurić I, Plavec D. Exhaled Breath Temperature as a Novel Marker of Future Development of COPD: Results of a Follow-Up Study in Smokers. COPD 2016; 13:741-749. [DOI: 10.3109/15412555.2016.1164129] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Marina Labor
- Department of Pulmonology, University Hospital Center Osijek, Osijek, Croatia
- Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
| | - Žarko Vrbica
- Department of Pulmonology and Immunology, General Hospital Dubrovnik, Dubrovnik, Croatia
- University of Dubrovnik, Dubrovnik, Croatia
| | - Ivan Gudelj
- Department of Pulmonology, University Hospital Center Split, Split, Croatia
| | - Slavica Labor
- Department of Pulmonology, University Hospital Center Osijek, Osijek, Croatia
- Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
| | - Iva Jurić
- Department of Cardiology, University Hospital Center Osijek, Osijek, Croatia
| | - Davor Plavec
- Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
- Research Department, Children's Hospital Srebrnjak, Zagreb, Croatia
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Carpagnano GE, Ruggieri C, Scioscia G, Storto MML, Zoppo L, Foschino-Barbaro MP. Is the Exhaled Breath Temperature Sensitive to Cigarette Smoking? COPD 2016; 13:642-6. [PMID: 26934668 DOI: 10.3109/15412555.2016.1143458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The smoking habit is accompanied by an acute inflammatory response which follows tissue injury. It would be desirable to find a non-invasive inflammatory marker that would simplify the task of studying and monitoring smokers more simply and allow us to identify populations at risk of contracting Chronic Obstructive Pulmonary Disease (COPD). Today's expectations regarding research focus on issues ranging from inflammatory markers to those of exhaled breath temperature (EBT) are considerable. That said, although the EBT has been largely studied in asthma and COPD, there have not been any studies thus far that have analysed the effect of cigarette smoking on the EBT. Bearing this in mind, in this longitudinal study we aim to analyse the EBT in current smokers, monitor the effects both of cigarette smoking on EBT and of what happens after smoking cessation. Twenty-five (25) smokers (59.5 ± 3.1 yrs, 12 M) who participated in a multi-disciplinary smoking cessation programme and 25 healthy never-smokers (58.7 ± 2.9, 13 M) underwent EBT measurement. EBT values were higher in smokers before smoking (T0) than in never-smokers [34.6 (34.2-35) vs 33.2 (32.4-33.7)°C, p < 0.001. The smokers repeated measurement 5 minutes after smoking a cigarette (T1) and 2 hours after (T2). They repeated EBC measurement after 1 week (T3) and then after 3 months (T4) from smoking cessation. EBT is higher in smokers compared to controls. EBT increases after cigarette smoking and progressively decreases with the increase of time from when the last cigarette was smoked. Thus, we can conclude that EBT is increased in smokers and also sensitive to the acute effect of cigarette smoke.
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Affiliation(s)
- Giovanna E Carpagnano
- a Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia , Italy
| | - Cinzia Ruggieri
- a Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia , Italy
| | - Giulia Scioscia
- a Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia , Italy
| | - Maria Maddalena Lo Storto
- a Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia , Italy
| | - Luigi Zoppo
- a Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia , Italy
| | - Maria P Foschino-Barbaro
- a Institute of Respiratory Disease, Department of Medical and Surgical Sciences, University of Foggia , Italy
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Bade G, Gupta S, Kabra SK, Talwar A. Slower rise of exhaled breath temperature in cystic fibrosis. Indian Pediatr 2015; 52:125-7. [DOI: 10.1007/s13312-015-0585-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Lázár Z, Bikov A, Martinovszky F, Gálffy G, Losonczy G, Horváth I. Exhaled breath temperature in patients with stable and exacerbated COPD. J Breath Res 2014; 8:046002. [PMID: 25234010 DOI: 10.1088/1752-7155/8/4/046002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The measurement of the peak exhaled breath temperature (EBT) during multiple tidal breaths offers an easy, non-invasive tool for monitoring airway inflammation. Chronic obstructive pulmonary disease (COPD) is linked to airway inflammation, which is further aggravated by exacerbations of the disease. However, the peak EBT has not been studied in patients with COPD. The breath temperature was measured (X-halo, Delmedica Investments) in 19 control non-smoking subjects (age: 28 ± 11 years, mean ± standard deviation), 19 control smoking/ex-smoking subjects (53 ± 9 years), 20 patients with stable COPD (66 ± 8 years), and 17 patients with COPD at onset and also after recovery from an acute exacerbation (AECOPD; 65 ± 10 years). Spontaneous sputa were collected in AECOPD. The intra-class correlation coefficient of the repeated EBT measurements in non-smokers was 0.87 (95% confidence interval: 0.70-0.95). The peak EBT was different between the subject groups (Kruskal-Wallis test, p = 0.02), with lower values in the patients with stable COPD (34.00/33.35-34.34/°C; median /interquartile range/) than in the smoking/ex-smoking control subjects (34.51/34.20-34.68/°C, p < 0.05). The EBT was higher at the onset of AECOPD (34.58/34.12-34.99/°C, p < 0.05) compared to in a stable condition, and positively correlated with the sputum leukocyte count (p = 0.049, r2 = 0.30; Spearman test) and neutrophil percentage (p = 0.03, r(2) = 0.36). The breath temperature decreased after recovery from AECOPD (34.10/33.72-34.43/°C, p = 0.008; Wilcoxon test). The peak exhaled breath temperature, recorded during multiple tidal breaths, increases with an acute exacerbation of COPD, and may be related to accelerated airway inflammation. The application of exhaled breath temperature measurements when monitoring the activity of COPD should be further assessed in longitudinal studies.
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Affiliation(s)
- Zsófia Lázár
- Department of Pulmonology, Semmelweis University, 1/c Diós árok, 1125 - Budapest, Hungary
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Carpagnano GE, Lacedonia D, Spanevello A, Martinelli D, Saliani V, Ruggieri C, Foschino-Barbaro MP. Exhaled breath temperature in NSCLC: Could be a new non-invasive marker? Med Oncol 2014; 31:952. [DOI: 10.1007/s12032-014-0952-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 03/28/2014] [Indexed: 12/18/2022]
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Bijnens E, Pieters N, Dewitte H, Cox B, Janssen BG, Saenen N, Dons E, Zeegers MP, Int Panis L, Nawrot TS. Host and environmental predictors of exhaled breath temperature in the elderly. BMC Public Health 2013; 13:1226. [PMID: 24365236 PMCID: PMC3890614 DOI: 10.1186/1471-2458-13-1226] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 12/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exhaled breath temperature has been suggested as a new method to detect and monitor pathological processes in the respiratory system. The putative mechanism of this approach is based upon changes in the blood flow. So far potential factors that influence breath temperature have not been studied in the general population. METHODS The exhaled breath temperature was measured in 151 healthy non-smoking elderly (aged: 60-80 years) at room temperature with the X-halo device with an accuracy of 0.03°C. We related exhaled breath temperature by use of regression models with potential predictors including: host factors (sex, age) and environmental factors (BMI, physical activity, and traffic indicators). RESULTS Exhaled breath temperature was lower in women than in men and was inversely associated with age, physical activity. BMI and daily average ambient temperature were positively associated with exhaled breath temperature. Independent of the aforementioned covariates, exhaled breath temperature was significantly associated with several traffic indicators. Residential proximity to major road was inversely associated with exhaled breath temperature: doubling the distance to the nearest major intense road was observed a decrease of 0.17°C (95% CI: -0.33 to -0.01; p=0.036). CONCLUSIONS Exhaled breath temperature has been suggested as a noninvasive method for the evaluation of airway inflammation. We provide evidence that several factors known to be involved in proinflammatory conditions including BMI, physical activity and residential proximity to traffic affect exhaled breath temperature. In addition, we identified potential confounders that should be taken into account in clinical and epidemiological studies on exhaled breath temperature including sex, age, and ambient temperature.
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Affiliation(s)
- Esmée Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Nicky Pieters
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Harrie Dewitte
- Department of Public Health, Leuven University (KU Leuven), Leuven, Belgium
- Primary health care center GVHV, Genk, Belgium
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Bram G Janssen
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Nelly Saenen
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Evi Dons
- VITO, Flemish Institute for Technological Research, Mol, Belgium
- Transportation Research Institute, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Luc Int Panis
- VITO, Flemish Institute for Technological Research, Mol, Belgium
- Transportation Research Institute, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
- Department of Public Health, Leuven University (KU Leuven), Leuven, Belgium
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Logie KM, Kusel MMH, Sly PD, Hall GL. Exhaled breath temperature in healthy children is influenced by room temperature and lung volume. Pediatr Pulmonol 2011; 46:1062-8. [PMID: 21626714 DOI: 10.1002/ppul.21488] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 04/20/2011] [Accepted: 04/20/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Exhaled breath temperature (EBT) has been proposed for the non-invasive assessment of airway inflammation. Previous studies have not examined the influence of room temperature or lung size on the EBT. OBJECTIVE This study aimed to address these issues in healthy children. METHODS We assessed the effects of room temperature and lung volume in 60 healthy children aged 9-11 years (mean age 10.3 years, 33 male). Static lung volumes were assessed using multiple breath nitrogen washout. Questionnaire and skin prick tests were also used to establish respiratory health in the children. We obtained the EBT parameters of slope, end plateau temperature (PLET) and normalized plateau temperature (nPLET; plateau temperature minus inspired air temperature), and ascertained physiological factors influencing EBT. RESULTS End plateau temperature was shown to be proportionally affected by room temperature (r = 0.532, P < 0.001) whereas slope and nPLET decreased with increasing room temperature (r = -0.392 P < 0.02 and r = -0.507 P = 0.002). After adjusting for room temperature, height and age, the total lung capacity (r(2) = 0.435, P = 0.006) and slow vital capacity (SVC; r(2) = 0.44, P = 0.005) were found to be the strongest predictors of end PLET in healthy children. When all factors were included in a multiple regression model, SVC and room temperature were the only predictors of plateau and nPLET. Slope was only influenced by room temperature. CONCLUSIONS Exhaled breath temperature measurements are highly feasible in children with a 95% success rate in this healthy population. Room temperature and SVC significantly influence EBT variables in healthy children. Further studies are required to investigate the ability of EBT to assess airway inflammation in children with respiratory disease. Pediatr. Pulmonol. 2011; 46:1062-1068. © 2011 Wiley Periodicals, Inc.
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Affiliation(s)
- Karla M Logie
- School of Paediatrics and Child Health, University of Western Australia, Subiaco, Western Australia, Australia.
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Flouris AD, Cheung SS. The validity of tympanic and exhaled breath temperatures for core temperature measurement. Physiol Meas 2010; 31:N35-42. [DOI: 10.1088/0967-3334/31/5/n01] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Paredi P, Ward S, Cramer D, Barnes PJ, Kharitonov SA. Normal bronchial blood flow in COPD is unaffected by inhaled corticosteroids and correlates with exhaled nitric oxide. Chest 2007; 131:1075-81. [PMID: 17426212 DOI: 10.1378/chest.06-2154] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In COPD patients, there is reduced vascularity and inflammation of the bronchi, which may have opposite effects on bronchial blood flow (QAW). We studied the relationship of QAW with the fraction of exhaled nitric oxide (FENO), which is a potent vasodilator. We also investigated the vascular response to budesonide and a beta(2)-agonist. METHODS We measured QAW in 17 patients with COPD (mean [+/- SEM] age, 67 +/- 3 years; 10 male patients; mean FEV(1), 57 +/- 3% predicted; mean FEV(1)/FVC ratio, 54 +/- 4%), all of whom were ex-smokers, and in 16 age-matched nonsmoking volunteers (mean age, 64 +/- 4 years) and compared this to FENO. QAW was measured using the acetylene dilution method. RESULTS Mean QAW was similar in patients with COPD (34.29 +/- 1.09 microL/mL/min) compared to healthy subjects (35.50 +/- 1.74 microL/mL/min; p > 0.05) and was not affected by long-term treatment (35.89 +/- 1.63 microL/mL/min) or short-term treatment (32.50 +/- 1.24 microL/mL/min; p < 0.05) with inhaled budesonide. QAW positively correlated with the diffusion of carbon monoxide (ie, carbon monoxide transfer coefficient: r = 0.74; p < 0.05). FENO levels were mildly elevated in steroid-treated patients (10.89 +/- 0.87 parts per billion [ppb]) and untreated patients (9.40 +/- 0.86 ppb) compared to the control group (8.22 +/- 0.57 ppb; p < 0.05) and were correlated with QAW (r = 0.6; p < 0.05). Ten minutes after the inhalation of 200 microg of albuterol, QAW was more elevated in healthy control subjects (59.33 +/- 2.40 microL/mL/min) compared to COPD patients (38.00 +/- 0.58 microL/mL/min; p < 0.05), indicating that COPD patients may have a reduced bronchial vascular reactivity. CONCLUSIONS QAW is normal in COPD patients and is not affected by therapy with inhaled corticosteroids or beta(2)-agonists. In addition, QAW correlates with levels of FENO, which may have a regulatory role.
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Affiliation(s)
- Paolo Paredi
- National Heart and Lung Institute, Airway Disease Section, Dovehouse St, London, SW3 6LY, UK.
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Paredi P, Kharitonov SA, Barnes PJ. Correlation of exhaled breath temperature with bronchial blood flow in asthma. Respir Res 2005; 6:15. [PMID: 15705206 PMCID: PMC553993 DOI: 10.1186/1465-9921-6-15] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2004] [Accepted: 02/10/2005] [Indexed: 12/02/2022] Open
Abstract
In asthma elevated rates of exhaled breath temperature changes (Δe°T) and bronchial blood flow (Qaw) may be due to increased vascularity of the airway mucosa as a result of inflammation. We investigated the relationship of Δe°T with Qaw and airway inflammation as assessed by exhaled nitric oxide (NO). We also studied the anti-inflammatory and vasoactive effects of inhaled corticosteroid and β2-agonist. Δe°T was confirmed to be elevated (7.27 ± 0.6 Δ°C/s) in 19 asthmatic subjects (mean age ± SEM, 40 ± 6 yr; 6 male, FEV1 74 ± 6 % predicted) compared to 16 normal volunteers (4.23 ± 0.41 Δ°C/s, p < 0.01) (30 ± 2 yr) and was significantly increased after salbutamol inhalation in normal subjects (7.8 ± 0.6 Δ°C/ s, p < 0.05) but not in asthmatic patients. Qaw, measured using an acetylene dilution method was also elevated in patients with asthma compared to normal subjects (49.47 ± 2.06 and 31.56 ± 1.6 μl/ml/min p < 0.01) and correlated with exhaled NO (r = 0.57, p < 0.05) and Δe°T (r = 0.525, p < 0.05). In asthma patients, Qaw was reduced 30 minutes after the inhalation of budesonide 400 μg (21.0 ± 2.3 μl/ml/min, p < 0.05) but was not affected by salbutamol. Δe°T correlates with Qaw and exhaled NO in asthmatic patients and therefore may reflect airway inflammation, as confirmed by the rapid response to steroids.
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Affiliation(s)
- Paolo Paredi
- Department of Thoracic Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK
| | - Sergei A Kharitonov
- Department of Thoracic Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK
| | - Peter J Barnes
- Department of Thoracic Medicine, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK
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