An increase in exhaled CO concentration in systemic inflammation/sepsis

Hiroshi Morimatsu, Toru Takahashi, Takashi Matsusaki, Masao Hayashi, Jyunya Matsumi, Hiroko Shimizu, Masaki Matsumi, Kiyoshi Morita

Research output: Contribution to journalShort surveypeer-review

15 Citations (Scopus)


Despite recent progress in Critical Care Medicine, sepsis is still a major medical problem with a high rate of mortality and morbidity especially in intensive care units. Oxidative stress induced by inflammation associated with sepsis causes degradation of heme protein, increases microsomal free heme content, promotes further oxidative stress and results in cellular and organ damage. Heme-oxygenase-1 (HO-1) is a rate-limiting enzyme for heme breakdown. HO-1 breaks down heme to yield CO, iron and biliverdin. Measurement of CO in exhaled air may potentially be useful in monitoring changes in HO enzyme activity in vivo, which might reflect the degree of inflammation or oxidative stress in patients with systemic inflammation. The increased exhaled CO concentrations were observed after anesthesia/surgery, in critically ill patients and also in systemic inflammation/sepsis. Some reports also showed that exhaled CO concentration is related to mortality. Further studies are needed to elucidate whether increased endogenous CO production may predict a patient's morbidity and mortality. Techniques for monitoring CO are continuously being refined and this technique may find its way into the office of clinicians.

Original languageEnglish
Article number47103
JournalJournal of Breath Research
Issue number4
Publication statusPublished - Dec 2010

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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