A simple breath sampling method in intubated and mechanically ventilated critically ill patients.
Volatile organic compounds (VOCs) in breath may serve as biomarkers of pulmonary infection or inflammation. We developed and validated a new breath sampling method for VOC analysis in ventilated patients. Breath was collected from the ventilatory circuit using cheap disposables. VOCs were identified by gas-chromatography and mass-spectrometry (GC-MS) at various minute volumes during ventilation of an artificial lung (in vitro) and ventilated patients (in vivo). Sixty-four VOCs emendated from the ventilator and tubing. Their concentrations had an inverse correlation with minute volume in in vitro experiments (median correlation coefficient: -0.61 [25-75th percentile: -0.66 to -0.43]). Forty-four of these "ventilator-associated VOCs" were also observed in vivo, without correlations with minute volume. In vivo experiments showed that only positive end-expiratory pressure influenced the concentration of breath VOCs. The sampling method was highly reproducible (median intra-class correlation 0.95 [25-75th percentile: 0.87-0.97]). In conclusion, a novel, simple and repeatable sampling method was developed and validated for capturing exhaled VOCs in ventilated patients, which could allow for large-scale breath analysis in clinical studies.
Department of Intensive Care, Academic Medical Center - University of Amsterdam, The Netherlands; Department of Respiratory Medicine, Academic Medical Center - University of Amsterdam, The Netherlands. Electronic address: 1.d.bos@amc.uva.nl.
Lieuwe D J
LD
Bos
Philips Research, Eindhoven, The Netherlands. Electronic address: yuanyue.wang@philips.com.
Yuanyue
Y
Wang
Philips Research, Eindhoven, The Netherlands. Electronic address: hans.weda@philips.com.
Hans
H
Weda
Philips Research, Eindhoven, The Netherlands. Electronic address: tamara.nijsen@philips.com.
Tamara M E
TM
Nijsen
Philips Research, Eindhoven, The Netherlands. Electronic address: apge.janssen@philips.com.
Anton P G E
AP
Janssen
Philips Research, Eindhoven, The Netherlands. Electronic address: hugo.knobel@philips.com.
Hugo H
HH
Knobel
Philips Research, Eindhoven, The Netherlands. Electronic address: anton.vink@philips.com.
Teunis J
TJ
Vink
Department of Intensive Care, Academic Medical Center - University of Amsterdam, The Netherlands. Electronic address: marcus.j.schultz@gmail.com.
Marcus J
MJ
Schultz
Department of Respiratory Medicine, Academic Medical Center - University of Amsterdam, The Netherlands. Electronic address: p.j.sterk@amc.uva.nl.
Peter J
PJ
Sterk
D000368:Aged; D015415:Biomarkers; D001944:Breath Tests / Q000379:methods*; D016638:Critical Illness; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012119:Respiration; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D055549:Volatile Organic Compounds
D015415:Biomarkers; D055549:Volatile Organic Compounds
Exhaled breath; Intensive care; Methodology; Volatile organic compounds