Heat production can be calculated from a measurement of VO 2 and/or CO 2. Doubly-Labeled Water Doubly-labeled water contains isotopes of oxygen and of hydrogen. The technique involves the consumption by the patient of the doubly-labeled water then the measurement of the amount of isotope in the person after a washout period of 7- 14 days. Most of the hydrogen and oxygen isotopes are lost through excretion and evaporation, but some of the oxygen isotope equilibrates with carbon dioxide and is expired in air.