title: Quantification of propionaldehyde in breath of patients after lung transplantation.
abstract: Oxygen-derived free radicals (ROS) have been identified to contribute significantly to ischemia-reperfusion (I/R) injury by initiating chain reactions with polyunsaturated membrane lipids (lipid peroxidation, LPO) resulting in the generation of several aldehydes and ketones. Due to their volatile nature these LPO products can be measured noninvasively in breath. We hypothesized that one of these markers, namely propionaldehyde, will be increased in lung and heart-lung transplant patients where severe oxidative stress due to I/R injury with early graft dysfunction represents one of the major postoperative complications resulting in prolonged ventilation and increased in-hospital morbidity and mortality. Expiratory air measurements for acetone, isoprene, and propionaldehyde were performed in seven patients after lung (n = 5) or heart-lung (n = 2) transplantation, ventilated patients (n = 12), and healthy volunteers (n = 17) using online ion-molecule reaction mass spectrometry. Increased concentrations of acetone (transplanted: 3812 [2347-12498]; ventilated: 1255 [276-1959]; healthy: 631 [520-784] ppbv; P < .001) and propionaldehyde (transplanted: 270 [70-424]; ventilated: 82 [41.8-142]; healthy: 1.7 [0.1-11.8] ppbv; P < .001) were found in expiratory air of transplanted and ventilated patients. Propionaldehyde resulting from spontaneous fragmentation of peroxides due to free radical-induced LPO after I/R injury in patients after lung or heart-lung transplantation can be quantified in expired breath.
authors: Department of Anaesthesiology, University Hospital Munich-Campus Großhadern, Ludwig-Maximilians University, Munich, Germany. Electronic address: Michael.Dolch@med.uni-muenchen.de.
authors: M E
authors: ME
authors: Dolch
authors: Department of Anaesthesiology, University Hospital Munich-Campus Großhadern, Ludwig-Maximilians University, Munich, Germany.
authors: A
authors: A
authors: Choukèr
authors: Department of Anaesthesiology, University Hospital Munich-Campus Großhadern, Ludwig-Maximilians University, Munich, Germany.
authors: C
authors: C
authors: Hornuss
authors: Department of Anaesthesiology, University Hospital Munich-Campus Großhadern, Ludwig-Maximilians University, Munich, Germany.
authors: L
authors: L
authors: Frey
authors: Department of Anaesthesiology, University Hospital Munich-Campus Großhadern, Ludwig-Maximilians University, Munich, Germany.
authors: M
authors: M
authors: Irlbeck
authors: VF Services GmbH, 6067 Absam, Austria.
authors: S
authors: S
authors: Praun
authors: VF Services GmbH, 6067 Absam, Austria.
authors: C
authors: C
authors: Leidlmair
authors: VF Services GmbH, 6067 Absam, Austria.
authors: J
authors: J
authors: Villinger
authors: Department of Anaesthesiology, University Hospital Munich-Campus Großhadern, Ludwig-Maximilians University, Munich, Germany.
authors: G
authors: G
authors: Schelling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000447:Aldehydes / Q000032:analysis*; D001944:Breath Tests; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D055815:Young Adult
chemical_list: D000447:Aldehydes; C005556:propionaldehyde
keywords: Ion-molecule reaction mass spectrometry; Lipid peroxidation; Lung transplantation; Oxidative stress; Propionaldehyde