Source: Annual Congress 2012 - Prognostic indices in respiratory infections
Disease area: Respiratory critical care

Abstract

Volatile organic compounds (VOC) in breath have been described as biomarkers of metabolism, oxidative stress and cancer. This pilot study was intended to find out whether VAP related breath biomarkers could be recognized by means of a smart and rapid combination of VOC sample preparation and analysis.
20 mechanically ventilated patients (10 with pneumonia, 10 controls) were investigated. 15 mL of alveolar gas were withdrawn from the respiratory circuit. VOCs were pre-concentrated by means of needle trap micro extraction (NTME) at the bedside and identified/ quantified by means of gas chromatography- mass spectrometry (GC/MS). Results were analysed using ANOVA on ranks.
Expired concentrations of VOC‘s ranged from (400 pptV to 3000 ppbV (0.02 to 14.2 nmol/L). Exhaled acetone concentrations were higher in control patients (median 2895 ppbV vs. 187 ppbV, p=0.037). VAP patients exhaled lower concentrations of C8 aldehydes (median 2.061 ppbV vs. 19.683 ppbV, p=0.013) than control patients. Exhaled pentane showed a tendency to higher concentrations in VAP patients (median 9.907 ppbV vs. 6.040 ppbV).
The NTME- GC/MS assay enabled reliable detection of volatile substances from ventilated patients in trace amounts. Elevated pentane concentrations indicate oxidative stress in VAP, reduced aldehyde concentrations may be due to chemical quenching through ROS or ONOO- present in the alveoli of pneumonia patients. Analysis of exhaled oxygenated compounds bears the potential of non invasive monitoring and recognition of pathological pulmonary processes.

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Citations should be made in the following way:
U. Grigat, P. Trefz, P. Fucs, J. Schubert, W. Miekisch (Rostock, Germany). Exhaled breath biomarkers in patients with ventilator associated pneumonia (VAP). Eur Respir J 2012; 40: Suppl. 56, 2517

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