Breath-condensate device

Abstract

A cartridge device (10) for collecting and analysing a breath condensate is disclosed. The device (10) comprises a condensation zone (12) to condense exhaled breath from a subject and cooling means operably connected to the condensation zone (12). The device includes further discrete regions (13) for detection of analyte and measurement of analyte. The condensation zone (12) has a fluid exit connecting the condensation zone (12) to the discrete regions (13).

Claims

1. A cartridge device for collecting and analysing a breath condensate, the device comprising a condensation zone to condense exhaled breath from a subject into a condensate, the condensation zone, being operably connectable to a cooling means, the device including one or more further discrete regions for detection of one or more analytes in the condensate and measurement of the one or more analytes, the cartridge device further comprising a fluid path connecting the condensation zone to the or each discrete region, and wherein a surface of the or each discrete region includes a respective surface coating, said respective surface coating including one or more reagents to engage the condensate in the respective discrete region and determine composition, and wherein the cartridge device is configured such that the condensate will form a film in the condensation zone, and wherein the condensation zone includes a condensing surface onto which the exhaled breath condenses to form the condensate as the film, and the condensing surface is arranged to form a contact angle of 20 with the breath condensate from the subject.

2. The cartridge device according to claim 1, wherein the device includes analysis initiation means to detect the presence of the condensate.

3. The cartridge device according to claim 1, wherein the or each discrete region has a specified volume, which allows the measurements to be calculated based upon the respective volume.

4. The cartridge device according to claim 3, wherein the specified volume of the or each discrete region is up to 4 I.

5. The cartridge device according to claim 1, wherein the or each discrete region has a specified volume such that there is an analyte detection zone of the or each discrete region whose volume is less than a predetermined volume of the condensate.

6. The cartridge device according to claim 1, wherein the respective surface coating has a thickness in a range of 1 m to 15 m.

7. The cartridge device according to claim 1, wherein the or each discrete region includes at least a pair of electrodes in operable connection with the condensation zone.

8. The cartridge device according to claim 7, wherein the cartridge device is configured to vary a difference in potential between the pair of electrodes.

9. The cartridge device according to claim 1, wherein the cartridge device is configured to have a further reagent added to said condensate in a further discrete preparation region.

10. The cartridge device according to claim 1, wherein the cartridge device is configured to have a further reagent for analysis of the condensate loaded into the condensate during passage of the condensate from the condensation zone to a respective one of the discrete regions.

11. The cartridge device according to claim 1, wherein at least one of the one or more discrete regions has a perimeter ranging from 2-10 mm.

12. The cartridge device according to claim 11, wherein the at least one of the one or more discrete regions has a perimeter of 5 mm.

13. The cartridge device according to claim 1, wherein at least one of the one or more discrete regions has a height of from 75-750 m.

14. The cartridge according to claim 13, wherein the at least of the one or more discrete regions has a height of 100 m.

15. The cartridge device according to claim 1, wherein at least one of the one or more discrete regions comprises a chamber, the chamber being enclosed on five sides with a sixth side open for the condensate to enter said chamber and for displaced air to escape therefrom.

16. The cartridge device according to claim 1, wherein the cartridge device is configured to measure interference to a measurement of the analyte.

17. The cartridge device according to claim 1, wherein the cartridge device is configured to determine power supplied to the condensation zone.

18. The cartridge device according to claim 1, wherein the device further comprises a hole or channel through which air can escape from the device, said hole or channel connecting at least one of the one or more discrete regions with atmosphere.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) The invention is now described with respect to the accompanying drawings which show, by way of example only, embodiments of a breath-condensate collector and analysing device. In the drawings:

(2) FIG. 1 illustrates the layout of a device;

(3) FIG. 1a further illustrates layout of a device;

(4) FIG. 1b is a further illustrative layout of a device;

(5) FIG. 2 illustrates a second embodiment of the device, including lids to retain sample and guide flow within the device;

(6) FIG. 3 illustrates further features of a device;

(7) FIG. 4 illustrates the layout of an embodiment of the device;

(8) FIG. 5 illustrates a close-up view of the layout of the sensing zone of the device;

(9) FIG. 6 illustrates an example of chemical reactions involved within the sensing chamber

(10) FIG. 7 illustrates an example of an embodiment of a film coating;

(11) FIG. 8 illustrates an alternative layout of the device;

(12) FIG. 9 illustrates an alternative layout of the device;

(13) FIG. 10 is a chart showing raw noise data;

(14) FIG. 11 is a chart showing electrical noise spikes; and

(15) FIGS. 12a-12f illustrate a valve system to prevent entry of the ambient air into a condensed sample.

DETAILED DESCRIPTION OF THE INVENTION

(16) The analysis of exhaled breath to determine physiological dysfunction in a person or animal has been known for many years. The presence or otherwise of components of the breath can show deficiencies in the body, such as lung function or cell function. To this end, devices have been developed, which aim to collect the exhaled breath, including the more volatile components, which are otherwise not captured and so escape analysis. In many devices, the breath is first condensed to liquid or solid form, which is then analysed.

(17) There are however problems which need to be overcome in obtaining an analytical result. Many devices leave the user with the problem of carrying out the analysis. Often the condensed sample needs to be transported to a location remote from that where the analysis was carried out. However, some of the breath components which need to be characterised, such as hydrogen peroxide, are inherently unstable and so will have decomposed to an extent before any analysis is carried out. Although steps can be taken to alleviate this problem, such as cooling the sample in transit and also extrapolating back, based on the time since the sample was taken, to an estimated value, these steps can be difficult to carry out and increase the error limits for any particular result.

(18) Carrying out an analysis in situ, directly the sample is taken, overcomes the above to a large extent, but brings with it the problems of analysis as, especially where an animal is concerned, this may be at a distance from any building. Also there will be a need for the analyst to have calibrated reagents to hand.

(19) The present invention seeks to alleviate the above disadvantages by providing a hand-held device, which both collects and analyses exhaled breath.

(20) To achieve this, in a broad aspect, the device firstly collects the condensate in a collector, then transports a sample of the condensate to an analyser, fluidly connected to the collector where analysis is carried out using a solid-state analytical element. The use of a solid-state element removes the need for calibration of liquid reagents and removes the risk of dilution errors. Such a device also provides a longer shelf life than conventional devices and is more easily manufactured. To reduce the number of moving parts within the device and so increase reliability, the condensate preferably moves through the device by capillary action, and also optionally using functionalised surfaces to increase flow between regions. Ideally, between condensation of the sample and analysis should be no more than 30 seconds.

(21) In more detail, the exhaled breath is condensed on a surface, optionally functionalised such that any functionalisation is optimised to maximise the efficiency of condensation and to maximise the flow under gravity or otherwise of condensate phase from the condensing zone to integrated fluidic channel provided. The device is laid out such that multiple chemical and biochemical steps can be carried out on the condensate either in parallel or sequentially. The channel layout provided, means that where chemicals and reagents are utilised during the analysis, these can be sequentially added to a sample as the sample flows over the series of chemical and reagent zones provided therefor. This arrangement allows unstable reagents, including those which are unstable in the presence of other reagents, to be prepared or stored in close proximity to one another, yet spatially separated to prevent interaction. Reagents and sample conditioning additives are able to be added at several different points within the device.

(22) Finally, the condensate enters one or more sensing chambers, each having a fixed volume. Any remaining reagents, which can include proteins, enzymes, macromolecules, surfactants, ions etc. necessary for the analysis can be present here as dry mobile or immobilised formulations in close or intermediate proximity to the final point of analysis. The specific analytes of interest can be detected in the final sensing chamber by the use of such reagents, which can further include antigens, antibodies, RNA, DNA, proteins, enzymes, etc. Analytes to be detected include, but are not limited to: glucose, lactate, ketones, hydrogen peroxide and nitric oxide and may be detected either directly or indirectly.

(23) Detection is preferably carried out electrochemically to increase the accuracy and reproducibility of results. In one embodiment, two parallel electrodes are provided, which when not in use are electrically isolated from each other. In the presence of a liquid between the electrodes, a soft short is caused which produces a measurable electric signal, which can be used to determine the level of analyte. Such a signal can also be used to determine the arrival of condensate into the cartridge and so initiate further analytical steps. In a further embodiment, not illustrated, 2 or more electrodes are provided.

(24) The reagents used are designed to give a signal that has a known relationship, such as being proportional, to the concentration of the analyte of interest. The reagents may be present in a form such as dried down in place, a lyophilized bead or a film or any other suitable form. The advantage of using a dried reagent is that such reagents tend to be more storage stable and their concentration is likely to be more accurately known. The reagent may be a film such as a polymer blend containing a biologically compatible polymer, a macro-biological molecule or a mediator. In addition, other reagents such as a biologically-compatible polymer, for example polyurethane, horse-radish peroxidase or a surfactant such as sodium dodecylsulphate can also be present. As examples of mediators, then for hydrogen peroxide analysis in particular, potassium ferrocyanide and/or ferricyanide can be used.

(25) As an example, illustrated in FIG. 6, hydrogen peroxide can be detected indirectly with the use of horse-radish peroxidase (HRP). The reduced form of HRP initially reacts with the hydrogen peroxide to produce an oxidised form. The oxidised form subsequently reacts with potassium hexacyanoferrate (II) (potassium ferrocyanide) to produce potassium hexacyanoferrate (III) (potassium ferricyanide). Potassium ferricyanide is then detected by use of an electrochemical method such as amperometry where the current flows from an electrode. The current flowing is proportional to the concentration of the produced potassium ferricyanide and the final current is therefore indirectly linked to the initial hydrogen peroxide concentration in the sample. In detecting the ferricyanide species, this is reduced back to the ferrocyanide.

(26) The temperature of the condensing zone can be set relative to ambient temperature. The power necessary to maintain the temperature difference can be utilised to determine the rate of generation of exhaled breath. To achieve this, the power necessary to maintain the temperature is monitored. As this is a function of the thermal energy generated by the change of phase of the exhaled breath to the liquid condensate phase, measurement of the energy can be converted into a volume of condensate produced.

(27) In a preferred embodiment, a Peltier device may be used to cool the condensing zone. The temperature on the face of the cooling zone itself may be static or dynamic. In a preferred embodiment the temperature would be around 10 C. although it should be appreciated that the temperature may change depending on the various parameters including ambient conditions. Should atmospheric air be excluded as in certain optional embodiments of the device then a lower temperature of around 5 C. can be used.

(28) The integrated nature of the device produced allows for the provision of a device whose operations require minimum interventions from an operator which removes a source of inaccuracy from the results. In addition, the lack of moving parts in preparation and analysis of the sample again improves the results obtained and also imparts a longer lifetime to the device. Further, the device can introduce multiple reagents into a sample, all of which reagents are stored within the device in a dry manner, which improves the shelf life of the reagents. Finally, the sample under analysis does not leave the device between the time of condensation and final detection, which minimises the risk of contamination or loss of sample. Furthermore, as elements used as part of the analysis can be disposed of following use, which again reduces the risk of cross-contamination. Yet further the analytical elements of the device can be incorporated into a removable section, such as a cartridge, which allows, once the collection elements of the device have been cleaned or otherwise readied for use, a new cartridge to be inserted ready for further use. Separate measurements on different subjects can thereby be rapidly made, and analysis on a subject be made, whilst the results are being obtained from a previous subject. Alternatively, measurements of different exhalates made for the same subject relatively close to each other in time.

(29) It is anticipated that the usable liquid volume within a cartridge is from 5-40 l and preferably 10-30 l.

(30) On analysis, the signal generated from the analyte or measurement of interest can be calibrated relative to a number of other signals, including the sensing zone temperature, sample conductivity, ambient temperature, etc. Again, therefore the errors caused by sensor variability within batches and between batches is removed both through the device characterisation at the point of use and also by factors determined during the device's manufacturing.

(31) In order to remove variations in analytical results carried out using electrodes, due to different concentrations of chloride ion in a sample, then a standard electrode concentration of chloride, typically a saturated solution, can be formed of the sample. This can be achieved through the condensate passing over a surface onto or within which a chloride, such as sodium chloride, has been added. This can be for example within a gel layer, from which chloride ions can readily diffuse out. Signals obtained from an electrode can therefore be attributed to an analyte of interest as the electrode response due to the salt can be filtered out.

(32) Signals from the analysis and also from the power usage of the cooling applied to the condensing zone can be fed to a processor, either attached to the device or externally, which then generates the data required by the user. Additionally, by performance of a mass-balance calculation on the condensate collected and the condensate entering the sensing chamber, the device can calculate the distribution of sample throughout the device and determine whether a cartridge has leaked or blocked, which allows quality checks to be built into the device.

(33) Referring now to FIG. 1, this illustrates a first embodiment of an integrated collection and analysis device. The device, generally referenced 10, is operatively linked to a mouthpiece (not shown here) through which exhaled breath is directed onto a breath collection portion 11 having a condensing zone 12. The condensing zone 12 is in fluid connection with the sensing zone 13 in which analysis of the collected condensed breath fluid can take place. It will be appreciated that when the device 10 is in fact held such that the condensing zone 12 is uppermost, then flow of fluid into the sensing zone 13 is facilitated by gravity. Although not illustrated in FIG. 1, the condensing zone 12 and sensing zone 13 are fluidly connected by one or more channels, to provide a controlled flow of fluid. The dimensions of a channel are of an order of magnitude less than those of the overall device 10 although the dimensions of a channel may vary depending on the function of the channel. Moreover, the dimensions of a channel can vary along the length of the channel. In a further non-illustrated embodiment, flow of the fluid from the condensing zone to the sensing zone is controlled by means of firstly collecting and holding the condensed fluid in one region and subsequently causing a portion of the collected fluid to flow into the sensing zone in defined aliquots.

(34) In a preferred embodiment the overall dimensions of the device 10 are 66 mm30 mm5 mm, as illustrated in FIGS. 4 and 5. The condensing zone 12 and the sensing zone 13 are each approximately circular in the preferred embodiment, although they can have a polygonal shape. The size can be varied to suit the use. The condensing zone 12 preferably is of larger dimension of the order of that of the entire device 10. The sensing zone 13 can have a perimeter of approximately between 2-10 mm and of approximately 5 mm. The height can be approximately from 75-750 m and especially of 100 m.

(35) FIG. 1a illustrates features of the device 10 in more detail. Breath is condensed on the condensing zone 12 and forms a film on the surface thereof. The condensed fluid exits the condensing zone 12 by capillary action, via the channels 18, which lead the fluid to the sensor element 19. The sensor element 19 as shown is a combined counter and reference electrode, although in a separate embodiment, these can be located separately. The working electrode 20 is housed as part of a ceramic sensor 21. Electrical contact pads 22 at the distal end of the ceramic sensor 21 enable electrical connection with corresponding elements on the apparatus housing into which the device 10 fits when in use. A cover 23 is provided (FIG. 1b) which then defines a microfluidic chamber beneath the cover 23.

(36) In order to aid correct alignment of the device 10 within a housing, key holes 24 are provided engaging corresponding projections in the housing. Additionally, to aid insertion of the device 10 into the housing the distal end 25 of the device 10 has a wedge shape. The sensor element 19, ceramic sensor 21 and cover 23 are held in position relative to the device body 10a by an epoxy resin fixing 26, although other fixing means, including mechanical, can also be utilised.

(37) In a further preferred embodiment, the or each channel (not illustrated) has a means of allowing air to leave the device 10, for example when the sample flows into a channel. An example of the means may be a further channel or an aperture through which the air can escape. This prevents air from getting trapped within the device 10 as the fluid flows in as the air has a route by which it may leave. An example of this embodiment is shown in FIG. 4 and in FIG. 5.

(38) In an alternative embodiment, the device may include an air escape channel 60 as illustrated in FIG. 4.

(39) In order to condense the exhaled breath, which comprises a mixture of gases and vapours, into one volume the condensing zone 12 is provided with cooling means. The constituent elements of the sensing zone 13 can also be provided with cooling or heating means, where required, to assist in the analysis of the breath condensate. For example, where an assay incorporates an enzymatically catalysed reaction, it is usually advantageous to carry out the reaction at around normal body temperature. An example of a heater which can be used to elevate the temperature of a reaction is a conductive strip, which can be screen-printed and secured to the back of a sensor adjacent a sensing zone. On passing a current through the strip, using for example Ohmic heating, the temperature can be controlled using a pulsed voltage across the heater.

(40) Additionally, or alternatively, a thermocouple sensor can also be included, preferably printed onto the sensor to achieve intimate contact with the sensor and give an accurate value for the sensor temperature. An external temperature sensor can however also be used.

(41) To facilitate collection of condensate in one region of the condensing zone 12, the condensing zone 12 can have a coated surface to direct condensed breath optionally towards a particular region of the condensing zone 12 which particular region can be maintained at a lower temperature than other regions of the condensing zone 12. The surface coating is preferably of a hydrophobic nature, but can also be or hydrophilic where suitable. Additionally, a coating can be provided which is both hydrophobic and lipophobic so that both oils and water run readily off the surface. Such coatings can be those known in the art such as perfluorinated polymers, for example that marketed under the trade name Teflon. When dried, the thickness of the coating can be in the range from 1 m to 15 m. The coating may swell to a greater thickness when it comes into contact with the sample. FIG. 7 shows an example of a coating by a film of a circular area. In this embodiment, the circular area covered by the film coating has a height of 5 m.

(42) One or both of the condensing zone 12 or sensing zone 13 (see FIG. 2) can be at least partially covered by a lid 14 or 15 respectively. In FIG. 2, a lid 14 is shown, located around the perimeter of the condensing zone 12, which lid 14 acts to retain condensate within the condensing zone 12. The lid 14, which partially covers the condensing zone 12, also acts to minimise outflow of breath from the collection portion 11, and restricts loss of breath which does not immediately condense on contact with the condensing zone 12. The open area between the perimeter regions allows the exhaled breath to reach the surface of the condensing zone 12.

(43) The lid 15, located over the sensing chambers of the sensing zone 13 and the channels, allows the volume to be controlled, and the sample to be retained, whilst also promoting wicking of the sample into and along a channel or channels. The volume of the sample is kept small through use of the lid to aid analysis, the lid also eliminating turbulent flow and mixing.

(44) FIG. 3 illustrates a device 30, having a further sample preparation zone 31, in which initial reagents or other modifiers can be added to the sample to facilitate the analysis in the sensing zone 32. The purity of the sample can also be determined prior to the sample passing through the sensing zone 32 and into the analysis region 33.

(45) The sensing chambers optionally are operatively connected to a sample sensor which determines whether a sample is present. Additionally, the level of sample within a sensing chamber can also be determined. Once a pre-set level is reached, the level sensor transmits a signal so that assay commences automatically without input from the operator. This reduces the time at which analysis begins.

(46) FIGS. 8 and 9 show alternative embodiments whereby the sensing zones 42, 52 may be laid out within the device 40, 50 either parallel to one another below the condensing zone 41, 51 (FIG. 8) or sequentially (FIG. 9).

(47) FIGS. 10 and 11 shows how interference from various sources both known and unknown, can distort the signal produced. In the preferred embodiment, the spikes within the raw signal will first be identified by the reader and contribution of the spikes will be removed from the raw signal before the analyte concentration is calculated.

(48) In an alternative embodiment of a device, not illustrated, the device includes control means to govern the passage of condensed fluid from the condensing zone to the sensing zone. This allows the condensed breath to be moved for analysis in a known, controlled manner.

(49) As an example, the breath can be collected with the device so oriented that the condensation zone and particularly the fluid connection between the condensation zone and the sensing zone is a non-vertical, perhaps horizontal orientation, so that fluid flows relatively slowly or perhaps unevenly therefrom. The cartridge can then be rotated either by hand, but optionally mechanically to provide a vertical orientation. This process can be made automatic in that a sensor, determining the presence of a sample, causes a signal to be sent to the cartridge, activating the means of rotation to the required orientation. The sensor can be linked via processor to a spirit level or the like so that current orientation of the cartridge and fluid connection is known.

(50) Additionally or alternatively, vibration means can be included to cause movement of fluid in the condensing zone by vibration of the condensing zone.

(51) In a further alternative embodiment, means are included to prevent saliva from a subject from reaching the condensing zone and so contaminating the breath sample. Saliva is known to have 10-100 times the hydrogen peroxide content than is present in the air from the lungs. Such a prevention means must be such as to not interfere with the normal breathing of the subject, often referred to as a Tidal Breathing technique. One option of the prevention means comprises a convoluted path, and optionally one or more valves. The prevention means can be brought together on a common housing with the device 10, such that breath exiting the prevention means is directed onto the condensing zone 12. The prevention means, usually formed into a mouthpiece into which a patient breathes, is preferably replaceable once used, to improve the hygiene and accuracy of the apparatus.

(52) In a yet further embodiment means can also be included to prevent humidity from the ambient air from condensing in the condensing zone and contaminating the sample, primarily by dilution, also possibly by introducing air-borne contaminants. This is illustrated in FIG. 12.

(53) One of the potential sources of contamination of the exhaled breath condensate is the co-incidental condensing of humidity from the ambient air, which will be an uncontrolled process causing uncontrolled hydrogen peroxide concentrations. The valve system illustrated in FIGS. 12a-12f prevents the ambient air from readily making its way to the Peltier cooler and being condensed within the cartridge. Additionally, the mouth piece 120 allows the effective use of accessories to be used if required, such as: saliva traps, filters, flow restrictors and nose clips. Therefore, the device can be used in several modes of operation depending on whether or which accessories are used.

(54) The use of valves and baffles ensures that the majority of the exhaled breath is now forced to pass within the vicinity of the cooled condensing zone of the cartridge, ensuring a good efficiency in condensing the exhaled breath vapour. The valved mouth piece can have one or more chambers within it, with chambers directly connected or connected via a valve. In the disclosed embodiment there are three chambers, with a valve between Chamber One 121 and Chamber Two 122, whilst Chamber Two 122 and Chamber Three 123 are in direct contact. In the illustrated embodiment, the mouth-piece is securable to a housing by means of external lugs 128.

(55) The logic of the valves is that all the valves are normally closed when the device is not in operation. Upon inhalation Valve Three 126 opens, whilst Valve One 124 and Valve Two 125 remain closed. Upon exhalation Valve Three 126 closes and Valves Two 125 and One 124 open. The device provides for the immediate analysis of exhaled breath condensate analytes, where the ambient air is precluded from the cartridge behind one or more normally closed valves. The device directing air into the lungs and from the lungs to the cartridge can have one or more chambers laid out either in series or parallel.

(56) As an example of valves suitable for the present invention, diaphragm valves can be cited. Diaphragm valves are used such that when a user is inhaling one valve opens to allow air in, whilst the other is closed. Upon exhalation, the valve state is reversed.

(57) The device is designed to ensure the efficient condensation of vapour from the breath by directing the exhaled breath across the surface of the cartridge's condensing zone. Typically, a condensate sample will be formed over a number of breath cycles taken over, for example, 60 seconds to collect sufficient breath condensate. Chambers can be connected to one another directly or connected via valves. During the breath cycle the flow of air is controlled to allow air into the lungs, whilst not exposing the cartridge to the ambient air; subsequently upon exhalation the exhaled breath is led along a path where the breath is passed over the cold zone before venting to the ambient. The judicious use of valves means ambient air is precluded from directly reaching the cartridge when the device is either operational or non-operational, with the logic of the valves as shown in Table 1. Additionally, the device has one or more ports which allow for air/gas exchange between the user, the ambient air and the air within the device. These ports can be used in conjunction with accessories including saliva traps, flow constrictors and filters etc., allowing several modes of action. Lastly the device can be used in conjunction with a device to prevent the flow of air through the user's nasal passages so as to force a mode of breathing where air passes only through the mouth.

(58) TABLE-US-00001 TABLE 1 Operation Valve Logic Comments Inhalation Valve Three: open This is to allow the user to inhale Valve Two: closed through the device whilst preventing the Valve One: closed air that is being inhaled flowing over the condensing zone. Exhalation Valve Three: closed The valve logic means the exhaled Valve Two: open breath has to follow a path where it Valve One: open flows within the vicinity of the cooled condensation zone on the cartridge leading to a more efficient condensation of the vapour within the exhaled breath. Not in Use Valve Three: closed When not in use, all the valves are Valve Two: closed closed and therefore reduces the Valve One: closed amount of ambient vapour that can be accidentally condensed within the device.

(59) In a still yet further embodiment of the device, the flow rate of the exhaled breath can be monitored, allowing a user or a supervising individual to allow the control of the flow rate or issue guidance. The sensor means for the flow rate may therefore be included within the device. The sensor thereby transmits real time data, which can provide visual or audio feedback, so that the breathing rate can be adjusted to stay within acceptable boundaries. Additionally, the breathing rate can be utilised as part of the diagnostic determination.

(60) An exemplary device may have the following three modes of operation:

(61) Mode OneAnalyse a subject's status from one or more real-time signals including: breath exhalate carbon dioxide levels, breath flow rate, breath water content, breath pressure; one or more of these signals are used to determine the status of the user, and/or their lung functionality.

(62) Mode TwoAnalyse a subject's status from a collected exhaled breath condensate, this measurement can be corrected for parameters such as breath exhalation profile, breath water content, breath carbon dioxide levels etc. For example, the carbon dioxide signal can be used to calculate the fractionated analyte concentration from the measured analyte concentration.

(63) Mode ThreeAnalyse a subject's status by combining the two modes described above, so that a breath condensate can be reported within the context of the overall exhaled breath profile and breath gas analysis.

(64) In a further exemplary embodiment, a mouthpiece employs an arrangement of baffles to minimise the chance of aerosol from the mouth reaching the condensation zone. In one arrangement air entering the mouthpiece encounters a first baffle which charges the air velocity by around 90. A second baffle then causes an approximately 180 change of direction. In this manner large droplets from the mouth are caused to drop out of the airflow, allowing vapour from the lungs through.

(65) The cartridge device is typically held, replaceably, within a housing to form an analysis apparatus, which housing includes features such as cooling, heating, processing means which can be used in co-operation with the cartridge device. The housing may comprise a cooling means, such as a Peltier plate, for cooling the cartridge to a suitable temperature for condensation. The cooling means may alternatively be part of the cartridge.

(66) The housing may comprise a heating means to heat a reaction zone which itself forms part of the cartridge. The heating means may be arranged in the housing or as part of the cartridge. There may be an electrical connection between the housing and the cartridge. The heating means may be an Ohmic heater.

(67) Heating and cooling means enable both condensation to a breath condensate film and subsequently performance of enzymatic assays upon the film. Furthermore, the sensor may be heated. Active heating of the sensor allows for operation of the cartridge in environments cooler than 10 to 15 Celsius.

(68) The housing may comprise a series of baffles to remove saliva aerosol from a vapour sample, so that substantially only vapour reaches the cartridge. Alternatively or additionally, a series of baffles may be provided in the cartridge. Yet alternatively, a single baffle may be provided in each of the housing and the cartridge.

(69) The housing may comprise a valve system to provide at least two flow paths through the complex device. Thus, an exhalation breath may be directed through a first flow path and an inhalation breath may be directed through a second flow path.

(70) The housing may further comprise a flow rate sensor for measuring breath flow rate.

(71) The housing may further comprise a carbon dioxide sensor for measuring a carbon dioxide concentration in breath.

(72) The housing may further comprise a humidity sensor. There may be more than one humidity sensor, for sensing the humidity of breath or ambient air, for example.

(73) The housing and/or the cartridge, preferably the cartridge may further comprise a temperature sensor for measuring breath temperature.

(74) The housing may further comprise a pressure sensor for measuring breath pressure during exhalation or inhalation.

(75) The housing may further comprise an electronic interface for providing information from one or more sensors to an external device and/or for receiving electrical energy from an external source. The electronic interface may provide information in an analogue or digital form.

(76) The housing may further comprise a data processing unit. The data processing unit may comprise an analogue to digital converter. The housing may further comprise a transmittal means to transmit information or data to an external device. Additionally, a data storage means can be included. The housing may comprise an electronic interface for a removable data storage means.

(77) The housing may further comprise an audio output to provide a user with feedback and/or instructions to assist the user with keeping breath parameters (such as pressure or flow rate or the like) within a desired range.

(78) The housing may further comprise a display. The display may provide a user with information about a breathing cycle in real time or in near real time. The display may provide a user with feedback and/or instructions to assist the user with keeping breath parameters (such as pressure or flow rate or the like) within a desired range.

(79) The apparatus can combine any number of signals to determine a patient's status or to calibrate a signal. Additionally, the device can open and close valves in response to defined conditions being met, for example the collection of fractionated breath by triggering valve when carbon dioxide level criteria are met.

(80) The apparatus is light and portable so can be picked up and placed in front of the mouth, and can be operated without being physically tethered to a power supply or third-party device.

(81) The apparatus is designed to be used with tidal breathing for greater patient acceptance, relative to previous devices which would require forced air manoeuvres.

(82) The apparatus aims to perform all the necessary functions involved within the workflow of collecting and analysing the breath condensate without manual interference or intervention by a user or clinician. The device may have both real-time sensing and analysis of the breath and physical parameter associated with breathing.

(83) In one preferred embodiment the breath condensate film is directed immediately from the subject's mouth through a tortuous flow path to the fully integrated apparatus (i.e. housing plus cartridge), where the breath is condensed into a breath film condensate upon a cooled zone. The resulting condensate film is immediately guided by a combination of capillary forces and gravity across a functionalised surface to a chamber. The film enters the chamber by following down the chamber's sides and filling the chamber from the bottom up. Finally, the condensate dissolves several salt patches; the dissolution of salt into the breath film condensate is electrically/electrochemically monitored and checked for the correct dissolution profile as part of onboard assay quality control. An incorrect profile is used to reject the cartridge.

(84) One inventive concept relates to a single integrated device for condensing breath as a film and analysing analytes within the exhaled breath condensate film. The device performs all the necessary functions involved within the workflow of collecting and analysing the breath condensate without manual interference or intervention by a user such as a clinician. The device includes a least one temperature zone for breath condensation that is integrated with at least one sensing zone for measurement upon the condensate.

(85) In the preferred embodiment of the apparatus the condensation zone is connected to the patient's mouth by a short tortuous flow path, designed to allow the passage of vapour from the lungs, and in particular, the alveolar part of the lung, whilst excluding aerosol from the mouth etc. Following condensation of exhaled breath, the film flows under the influence of gravity and capillary forces into a chamber, which is closed on five sides; the film flows down the sides of the chamber effectively filling the chamber from the bottom up.

(86) Near the completion of filling the chamber the breath film condensate dissolves patches of salt, the salt is necessary for both fixing the potential at a silver/silver chloride reference electrode and for providing a relatively low impedance sample.