Buffered end-tidal (BET) sampling—a novel method for real-time breath-gas analysis

We present a novel method for real-time breath-gas analysis using mass-spectrometric techniques: buffered end-tidal (BET) on-line sampling. BET has several advantages over conventional direct on-line sampling where the subject inhales and exhales through a sampling tube. In our approach, a single exhalation is administered through a tailored tube in which the end-tidal fraction of the breath-gas sample is buffered. This increases sampling time by an order of magnitude to several seconds, improving signal quality and reducing the total measurement time per test subject. Furthermore, only one exhalation per minute is required for sampling and the test subject can otherwise maintain a normal breathing pattern, thereby reducing the risk of hyperventilation. To validate our new BET sampling method we conducted comparative measurements with direct on-line sampling using proton-transfer-reaction mass spectrometry. We find excellent agreement in measured acetone and acetonitrile concentrations. High variability observed in breath-by-breath isoprene concentrations is attributed to differences in exhalation depth and influences of hyperventilation on end-tidal concentrations.