Effects of breathing pattern and inspired air conditions on breath condensate volume, pH, nitrite, and protein concentrations

Background: The effects of breathing pattern and inspired air conditions on the volume and content of exhaled breath condensate (EBC) were investigated. Methods: Total exhaled water (TEW), EBC volume, pH, nitrite and protein concentrations were measured in three groups of 10 healthy subjects breathing into a condenser at different target minute ventilations (Vm), tidal volumes (Vt), and inspired air conditions. Results: The volumes of both TEW and EBC increased significantly with Vm. For Vm 7.5, 15 and 22.5 l/ min, mean (SD) EBC was 627 (258) mul, 1019 (313) mul, and 1358 (364) mul, respectively (p< 0.001) and TEW was 1879 ( 378) ml, 2986 ( 496) ml, and 4679 ( 700) ml, respectively ( p< 0.001). TEW was significantly higher than EBC, reflecting a condenser efficiency of 40% at a target Vm of 7.5 l/ min which reduced to 29% at Vm 22.5 l/ min. Lower Vt gave less TEW than higher Vt (26.6 v 30.7 mul/l, mean difference 4.1 (95% CI 2.6 to 5.6), p< 0.001) and a smaller EBC volume (4.3 v 7.6 μl/l, mean difference 3.4 ( 95% CI 2.3 to 4.5), p< 0.001). Cooler and drier inspired air yielded less water vapour and less breath condensate than standard conditions ( p< 0.05). Changes in the breathing pattern had no effect on EBC protein and nitrite concentrations and pH. Conclusion: These results show that condensate volume can be increased by using high Vt and increased Vm without compromising the dilution of the sample.