Response-to-comments about: "Is it really the method for carbon dioxide determination in human postmortem cardiac gas samples using Headspace-Gas Chromatography-Mass Spectrometry valid?" from T. Saffaj and B. Ihssane

Saffaj et al. recently criticized our method of monitoring carbon dioxide in human postmortem cardiac gas samples using Headspace-Gas Chromatography-Mass Spectrometry. According to the authors, their demonstration, based on the latest SFSTP guidelines (established after 2007 [1,2]) fitted for the validation of drug monitoring bioanalytical methods, has put in evidence potential errors. However, our validation approach was built using SFSTP guidelines established before 2007 [3-6]. We justify the use of these guidelines because of the post-mortem context of the study (and not clinical) and the gaseous state of the sample (and not solid or liquid). Using these guidelines, our validation remains correct.

Transcutaneous carbon dioxide tension in newborn infants: reliability and safety of continuous 24-hour measurement at 42 degrees C.

In 58 newborn infants a new iridium oxide sensor was evaluated for transcutaneous carbon dioxide (tcPCO2) monitoring at 42 degrees C with a prolonged fixation time of 24 hours. The correlation of tcPCO2 (y; mm Hg) v PaCO2 (x; mm Hg) for 586 paired values was: y = 4.6 + 1.45x; r = .89; syx = 6.1 mm Hg. The correlation was not influenced by the duration of fixation. The transcutaneous sensor detected hypocapnia (PaCO2 less than 35 mm Hg) in 74% and hypercapnia (PCO2 greater than 45 mm Hg) in 74% of all cases. After 24 hours, calibration shifts were less than 4 mm Hg in 90% of the measuring periods. In 86% of the infants, no skin changes were observed; in 12% of infants, there were transitional skin erythemas and in 2% a blister which disappeared without scarring. In newborn infants with normal BPs, continuous tcPCO2 monitoring at 42 degrees C can be extended for as many as 24 hours without loss of reliability or increased risk for skin burns.

A combined ear sensor for pulse oximetry and carbon dioxide tension monitoring: accuracy in critically ill children.

IMPLICATIONS: A new combined ear sensor was tested for accuracy in 20 critically ill children. It provides noninvasive and continuous monitoring of arterial oxygen saturation, arterial carbon dioxide tension, and pulse rate. The sensor proved to be clinically accurate in the tested range.

Transthoracic adrenal biopsy procedure using artificial carbon dioxide pneumothorax as outpatient procedure.

Many routes have been described for percutaneous adrenal gland biopsy. They require either a complex non-axial path or a long hydrodissection or even pass through an organ thereby increasing complications. We describe here an approach using an artificially-induced carbon dioxide (CO2) pneumothorax, performed as an outpatient procedure in a 57-year-old woman. Under local anaesthesia, 200 ml of CO2 was injected in the pleural space through a Veress needle under computed tomography fluoroscopy, to clear the lung parenchyma from the biopsy route. Using this technique, transthoracic adrenal biopsy can be performed under simple local anaesthesia as an safely outpatient procedure.

Transcutaneous carbon dioxide and oxygen tension in newborn infants: reliability of a combined monitor of oxygen tension and carbon dioxide tension.

We evaluated a new combined sensor for monitoring transcutaneous carbon dioxide tension (PtcCO2) and oxygen tension (PtcO2) in 20 critically ill newborn infants. Arterial oxygen tension (PaO2) ranged from 16 to 126 torr and arterial carbon dioxide tension (PaCO2) from 14 to 72 torr. Linear correlation analysis (100 paired values) of PtcO2 versus PaO2 showed an r value of 0.75 with a regression equation of PtcO2 = 8.59 + 0.905 (PaO2), while PtcCO2 versus PaCO2 revealed a correlation coefficient of r = 0.89 with an equation of PtcCO2 = 2.53 + 1.06 (PaCO2). The bias between PaO2 and PtcO2 was -2.8 with a precision of +/- 16.0 torr (range, -87 to +48 torr). The bias between PaCO2 and PtcCO2 was -5.1 with a precision of +/- 7.3 torr (range, -34 to +8 torr). The transcutaneous sensor detected 83% of hypoxia (PaO2 less than 45 torr), 75% of hyperoxia (PaO2 greater than 90 torr), 45% of hypocapnia (PaCO2 less than 35 torr), and 96% of hypercapnia (PaCO2 greater than 45 torr). We conclude that the reliability of the combined transcutaneous PO2 and PCO2 monitor in sick neonates is good for detecting hypercapnia, fair for hypoxia and hyperoxia, but poor for hypocapnia. It is an improvement in that it spares available skin surface and requires less handling, but it appears to be slightly less accurate than the single electrodes.

Carbon dioxide efflux in a rhodic hapludox as affected by tillage systems in southern Brazil

Agricultural soils can act as a source or sink of atmospheric C, according to the soil management. This long-term experiment (22 years) was evaluated during 30 days in autumn, to quantify the effect of tillage systems (conventional tillage-CT and no-till-NT) on the soil CO2-C flux in a Rhodic Hapludox in Rio Grande do Sul State, Southern Brazil. A closed-dynamic system (Flux Chamber 6400-09, Licor) and a static system (alkali absorption) were used to measure soil CO2-C flux immediately after soybean harvest. Soil temperature and soil moisture were measured simultaneously with CO2-C flux, by Licor-6400 soil temperature probe and manual TDR, respectively. During the entire month, a CO2-C emission of less than 30 % of the C input through soybean crop residues was estimated. In the mean of a 30 day period, the CO2-C flux in NT soil was similar to CT, independent of the chamber type used for measurements. Differences in tillage systems with dynamic chamber were verified only in short term (daily evaluation), where NT had higher CO2-C flux than CT at the beginning of the evaluation period and lower flux at the end. The dynamic chamber was more efficient than the static chamber in capturing variations in CO2-C flux as a function of abiotic factors. In this chamber, the soil temperature and the water-filled pore space (WFPS), in the NT soil, explained 83 and 62 % of CO2-C flux, respectively. The Q10 factor, which evaluates CO2-C flux dependence on soil temperature, was estimated as 3.93, suggesting a high sensitivity of the biological activity to changes in soil temperature during fall season. The CO2-C flux measured in a closed dynamic chamber was correlated with the static alkali adsorption chamber only in the NT system, although the values were underestimated in comparison to the other, particularly in the case of high flux values. At low soil temperature and WFPS conditions, soil tillage caused a limited increase in soil CO2-C flux.

Emission of nitrous oxide and carbon dioxide from semi-arid tropical soils in Chiapas México

The semi-arid region of Chiapas is dominated by N2 -fixing shrubs, e.g., Acacia angustissima. Urea-fertilized soil samples under maize were collected from areas covered and uncovered by A. angustissima in different seasons and N2O and CO2 emissions were monitored. The objective of this study was to determine the effects of urea and of the rainy and dry season on gas emissions from semi-arid soil under laboratory conditions. Urea and soil use had no effect on CO2 production. Nitrons oxide emission from soil was three times higher in the dry than in the rainy season, while urea fertilization doubled emissions. Emissions were twice as high from soil sampled under A. angustissima canopy than from arable land, but 1.2 lower than from soil sampled outside the canopy, and five times higher from soil incubated at 40 % of the water-holding capacity (WHC) than at soil moisture content, but 15 times lower than from soil incubated at 100 WHC. It was found that the soil sampling time and water content had a significant effect on N2O emissions, while N fertilizer and sampling location were less influent.

Carbon dioxide evolution from snow-covered agricultural ecosystems in Finland

Selostus: Hiilidioksidin kulku lumipeitteisessä ja paljaassa maassa

Transcutaneous carbon dioxide pressure for monitoring patients with severe croup.

In a prospective investigation of 17 children with severe croup, we analyzed the effect of epinephrine inhalations and mild sedation with chloral hydrate on transcutaneous carbon dioxide pressure (tcPCO2), pulse oximetry measurements, and croup scores. There was a highly significant reduction (p less than 0.001) in the tcPCO2 values and croup scores after inhalation of epinephrine. The changes in the tcPCO2 values correlated with the clinical findings. Mild sedation also significantly improved the croup scores but failed to influence the tcPCO2 values. There was not statistically significant difference in pulse oximetry saturation, fraction of administered oxygen, heart rate, or respiratory rate before and after inhalation of epinephrine or chloral hydrate administration. Monitoring tcPCO2 appears to be a reliable and objective tool for managing patients with upper airway obstruction, whereas croup scores may be misleading.

End-tidal carbon dioxide monitoring using a naso-buccal sensor is not appropriate to monitor capnia during non-invasive ventilation.

BACKGROUND: In acute respiratory failure, arterial blood gas analysis (ABG) is used to diagnose hypercapnia. Once non-invasive ventilation (NIV) is initiated, ABG should at least be repeated within 1 h to assess PaCO2 response to treatment in order to help detect NIV failure. The main aim of this study was to assess whether measuring end-tidal CO2 (EtCO2) with a dedicated naso-buccal sensor during NIV could predict PaCO2 variation and/or PaCO2 absolute values. The additional aim was to assess whether active or passive prolonged expiratory maneuvers could improve the agreement between expiratory CO2 and PaCO2. METHODS: This is a prospective study in adult patients suffering from acute hypercapnic respiratory failure (PaCO2 ≥ 45 mmHg) treated with NIV. EtCO2 and expiratory CO2 values during active and passive expiratory maneuvers were measured using a dedicated naso-buccal sensor and compared to concomitant PaCO2 values. The agreement between two consecutive values of EtCO2 (delta EtCO2) and two consecutive values of PaCO2 (delta PaCO2) and between PaCO2 and concomitant expiratory CO2 values was assessed using the Bland and Altman method adjusted for the effects of repeated measurements. RESULTS: Fifty-four datasets from a population of 11 patients (8 COPD and 3 non-COPD patients), were included in the analysis. PaCO2 values ranged from 39 to 80 mmHg, and EtCO2 from 12 to 68 mmHg. In the observed agreement between delta EtCO2 and deltaPaCO2, bias was -0.3 mmHg, and limits of agreement were -17.8 and 17.2 mmHg. In agreement between PaCO2 and EtCO2, bias was 14.7 mmHg, and limits of agreement were -6.6 and 36.1 mmHg. Adding active and passive expiration maneuvers did not improve PaCO2 prediction. CONCLUSIONS: During NIV delivered for acute hypercapnic respiratory failure, measuring EtCO2 using a dedicating naso-buccal sensor was inaccurate to predict both PaCO2 and PaCO2 variations over time. Active and passive expiration maneuvers did not improve PaCO2 prediction. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01489150.

Separation of ammonia and carbon dioxide by adsorption

Tässä työssä on tutkittu ammoniakin ja hiilidioksidin erottamista adsorptio prosessilla ja suunniteltiin paineen muunteluun perustuvan adsorptioprosessin (PSA) käyttöä. Työn tarkoituksena oli laskea adsorptioon perustuvan prosessin kannattavuus melamiinitehtaan poistokaasujen erotuksessa. Tätä varten työssä suunniteltiin tehdasmitta-kaavainen prosessi ja arvioitiin sen kannattavuus. Työssä mitattiin adsorptiotasapainot, joiden perusteella sovitettiin sopiva kokeellinen adsorptioisotermi. Adsorptioisotermi lisättiin simulointiohjelmaan, jonka avulla suunniteltiin kaksi vaihtoehtoista pilot laitteistoa kaasujen erottamiseksi. Toisella pilot laitteistolla saadaan mitattua vain läpäisykäyrät, mutta paremmalla versiolla saadaan myös tietoa erotettujen komponenttien puhtaudesta. Suunnittelun tärkeimpiä lähtökohtia on molempien komponenttien mahdollisimman korkea puhtaus ja talteenottoaste. Täysimittakaavainen tehdas suunniteltiin simulointiohjelmiston avulla kahdelle eri kapasiteetille ja arvioitiin niiden kustannukset ja kannattavuus. Adsorptioprosessit osoittautuivat kannattaviksi kaasuseoksen erottamisessa kummassakin tapauksessa

Perspectives in the use of carbon dioxide

The mitigation of carbon dioxide is one of the scientific and technological challenges of the 2000s. Among the technologies that are under assessment, the recovery of carbon dioxide from power plants or industrial flue gases plays a strategic role. Recovered carbon dioxide can be either disposed in natural fields or used. The availability of large amounts of carbon dioxide may open new routes to its utilisation in biological, chemical and innovative technological processes. In this paper, the potential of carbon dioxide utilisation in the short-, medium-term is reviewed.

Nocturnal Transcutaneous Carbon Dioxide and Early Changes in Atherosclerosis in Pre- and Postmenopausal Women

The risk of cardiovascular diseases and sleep-disordered breathing increases after menopause. This cross-sectional study focuses on overnight transcutaneous carbon dioxide (TcCO₂) measurements and their power to predict changes in the early markers of cardiovascular and metabolic diseases. The endothelial function of the brachial artery, the intima-media thickness of the carotid artery, blood pressure, glycosylated hemoglobin A1C and plasma levels of cholesterols and triglycerides were used as markers of cardiovascular and metabolic diseases. The study subjects consisted of healthy premenopausal women of 46 years of age and postmenopausal women of 56 years of age. From wakefulness to sleep, the TcCO₂ levels increased more in postmenopausal women than in premenopausal women. In estrogen-users the increase in TcCO₂ levels was even more pronounced than in other postmenopausal women. From the dynamic behaviour of the nocturnal TcCO₂ signal, several important features were detected. These TcCO₂ features had a remarkable role in the prediction of endothelial dysfunction and thickening of the carotid wall in healthy premenopausal women. In addition, these TcCO₂ features were linked with blood pressure, lipid profile and glucose balance in postmenopausal women. The nocturnal TcCO₂ profile seems to contain significant information, which is associated with early changes in cardiovascular diseases in middle-aged women. TcCO₂ might not only measure the tissue carbon dioxide levels, but the TcCO₂ signal variation may also reflect peripheral vasodynamic events caused by increased sympathetic activity during sleep.