Detection and quantification of exhaled volatile organic compounds in mechanically ventilated patients - comparison of two sampling methods
Exhaled breath analysis is a promising new diagnostic tool, but currently no standardised method for sampling is available in mechanically ventilated patients. We compared two breath sampling methods, first using an artificial ventilator circuit, then in "real life" in mechanically ventila...
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| Veröffentlicht in: | Analyst (London) 2021-01, Vol.146 (1), p.222-231 |
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| creator | van Oort, Pouline M. P White, Iain R Ahmed, Waqar Johnson, Craig Bannard-Smith, Jonathan Felton, Timothy Bos, Lieuwe D Goodacre, Royston Dark, Paul Fowler, Stephen J |
| description | Exhaled breath analysis is a promising new diagnostic tool, but currently no standardised method for sampling is available in mechanically ventilated patients. We compared two breath sampling methods, first using an artificial ventilator circuit, then in "real life" in mechanically ventilated patients on the intensive care unit. In the laboratory circuit, a 24-component synthetic-breath volatile organic compound (VOC) mixture was injected into the system as air was sampled: (A) through a port on the exhalation limb of the circuit and (B) through a closed endo-bronchial suction catheter. Sorbent tubes were used to collect samples for analysis by thermal desorption-gas chromatography-mass spectrometry. Realistic mechanical ventilation rates and breath pressure-volume loops were established and method detection limits (MDLs) were calculated for all VOCs. Higher yields of VOCs were retrieved using the closed suction catheter; however, for several VOCs MDLs were compromised due to the background signal associated with plastic and rubber components in the catheters. Different brands of suction catheter were compared. Exhaled VOC data from 40 patient samples collected at two sites were then used to calculate the proportion of data analysed above the MDL. The relative performance of the two methods differed depending on the VOC under study and both methods showed sensitivity towards different exhaled VOCs. Furthermore, method performance differed depending on recruitment site, as the centres were equipped with different brands of respiratory equipment, an important consideration for the design of multicentre studies investigating exhaled VOCs in mechanically ventilated patients.
Exhaled breath analysis is a promising new diagnostic tool, but currently no standardised method for sampling is available in mechanically ventilated patients. We identified potential sources of bias as illustrated in this figure. |
| doi_str_mv | 10.1039/c9an01134j |
| format | Article |
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Exhaled breath analysis is a promising new diagnostic tool, but currently no standardised method for sampling is available in mechanically ventilated patients. We identified potential sources of bias as illustrated in this figure.</description><subject>Breath Tests</subject><subject>Catheters</subject><subject>Circuits</subject><subject>Diagnostic software</subject><subject>Diagnostic systems</subject><subject>Exhalation</subject><subject>Gas chromatography</subject><subject>Gas Chromatography-Mass Spectrometry</subject><subject>Humans</subject><subject>Mass spectrometry</subject><subject>Mathematical analysis</subject><subject>Respiration, Artificial</subject><subject>Sampling methods</subject><subject>Sorbents</subject><subject>Suction</subject><subject>Suctioning</subject><subject>Tubes</subject><subject>VOCs</subject><subject>Volatile organic compounds</subject><subject>Volatile Organic Compounds - analysis</subject><issn>0003-2654</issn><issn>1364-5528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtrHDEQhIVxsDdOLr7bCHwJgUmk1Wt0NJs3Jrkk50Er9Xi1aKSxNOPEvyF_OvKuY4NPTVd_VTQUQqeUvKOE6fdWm0goZXx7gBaUSd4IsWwP0YIQwpqlFPwYvSxlW1dKBDlCx4xVI1Vkgf5-gAns5FPEJjp8M5s4-d5bs5NSj-HPxgRw-DaFqgXAKV-b6C22aRjTHF3BPuIB7OZeNSHc4VuoGZWurrF66lZws-NN9mUfO_1OuJhhDD5eV_e0Sa68Qi96Ewq8fpgn6Nenjz9XX5qrH5-_ri6vGssUmxqlnWi1k5q2Qiqwa6mhVZS4teOKGtVrwd1SSgDqnCBAibJcOgKGMmBcsRP0Zp875nQzQ5m6wRcLIZgIaS7dkgvOiWwpr-jFM3Sb5hzrd5VSkgrFtKzU2z1lcyolQ9-N2Q8m33WUdPcVdSt9-X1X0bcKnz9EzusB3CP6v5MKnO2BXOzj9alj9g9x25eq</recordid><startdate>20210104</startdate><enddate>20210104</enddate><creator>van Oort, Pouline M. 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P ; White, Iain R ; Ahmed, Waqar ; Johnson, Craig ; Bannard-Smith, Jonathan ; Felton, Timothy ; Bos, Lieuwe D ; Goodacre, Royston ; Dark, Paul ; Fowler, Stephen J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-79d589d6918567ecb69e8710dbd471a7f954d266ee1dd50e107c46d0ea13e3473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Breath Tests</topic><topic>Catheters</topic><topic>Circuits</topic><topic>Diagnostic software</topic><topic>Diagnostic systems</topic><topic>Exhalation</topic><topic>Gas chromatography</topic><topic>Gas Chromatography-Mass Spectrometry</topic><topic>Humans</topic><topic>Mass spectrometry</topic><topic>Mathematical analysis</topic><topic>Respiration, Artificial</topic><topic>Sampling methods</topic><topic>Sorbents</topic><topic>Suction</topic><topic>Suctioning</topic><topic>Tubes</topic><topic>VOCs</topic><topic>Volatile organic compounds</topic><topic>Volatile Organic Compounds - analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Oort, Pouline M. P</creatorcontrib><creatorcontrib>White, Iain R</creatorcontrib><creatorcontrib>Ahmed, Waqar</creatorcontrib><creatorcontrib>Johnson, Craig</creatorcontrib><creatorcontrib>Bannard-Smith, Jonathan</creatorcontrib><creatorcontrib>Felton, Timothy</creatorcontrib><creatorcontrib>Bos, Lieuwe D</creatorcontrib><creatorcontrib>Goodacre, Royston</creatorcontrib><creatorcontrib>Dark, Paul</creatorcontrib><creatorcontrib>Fowler, Stephen J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Engineered Materials Abstracts</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>METADEX</collection><collection>Technology Research Database</collection><collection>Materials Research Database</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>MEDLINE - Academic</collection><jtitle>Analyst (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Oort, Pouline M. P</au><au>White, Iain R</au><au>Ahmed, Waqar</au><au>Johnson, Craig</au><au>Bannard-Smith, Jonathan</au><au>Felton, Timothy</au><au>Bos, Lieuwe D</au><au>Goodacre, Royston</au><au>Dark, Paul</au><au>Fowler, Stephen J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection and quantification of exhaled volatile organic compounds in mechanically ventilated patients - comparison of two sampling methods</atitle><jtitle>Analyst (London)</jtitle><addtitle>Analyst</addtitle><date>2021-01-04</date><risdate>2021</risdate><volume>146</volume><issue>1</issue><spage>222</spage><epage>231</epage><pages>222-231</pages><issn>0003-2654</issn><eissn>1364-5528</eissn><abstract>Exhaled breath analysis is a promising new diagnostic tool, but currently no standardised method for sampling is available in mechanically ventilated patients. We compared two breath sampling methods, first using an artificial ventilator circuit, then in "real life" in mechanically ventilated patients on the intensive care unit. In the laboratory circuit, a 24-component synthetic-breath volatile organic compound (VOC) mixture was injected into the system as air was sampled: (A) through a port on the exhalation limb of the circuit and (B) through a closed endo-bronchial suction catheter. Sorbent tubes were used to collect samples for analysis by thermal desorption-gas chromatography-mass spectrometry. Realistic mechanical ventilation rates and breath pressure-volume loops were established and method detection limits (MDLs) were calculated for all VOCs. Higher yields of VOCs were retrieved using the closed suction catheter; however, for several VOCs MDLs were compromised due to the background signal associated with plastic and rubber components in the catheters. Different brands of suction catheter were compared. Exhaled VOC data from 40 patient samples collected at two sites were then used to calculate the proportion of data analysed above the MDL. The relative performance of the two methods differed depending on the VOC under study and both methods showed sensitivity towards different exhaled VOCs. Furthermore, method performance differed depending on recruitment site, as the centres were equipped with different brands of respiratory equipment, an important consideration for the design of multicentre studies investigating exhaled VOCs in mechanically ventilated patients.
Exhaled breath analysis is a promising new diagnostic tool, but currently no standardised method for sampling is available in mechanically ventilated patients. We identified potential sources of bias as illustrated in this figure.</abstract><cop>England</cop><pub>Royal Society of Chemistry</pub><pmid>33103170</pmid><doi>10.1039/c9an01134j</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-4524-1663</orcidid><orcidid>https://orcid.org/0000-0003-2230-645X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Analyst (London), 2021-01, Vol.146 (1), p.222-231 |
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| source | MEDLINE; Royal Society of Chemistry Journals Archive (1841-2007); Royal Society Of Chemistry Journals 2008-; Alma/SFX Local Collection |
| subjects | Breath Tests Catheters Circuits Diagnostic software Diagnostic systems Exhalation Gas chromatography Gas Chromatography-Mass Spectrometry Humans Mass spectrometry Mathematical analysis Respiration, Artificial Sampling methods Sorbents Suction Suctioning Tubes VOCs Volatile organic compounds Volatile Organic Compounds - analysis |
| title | Detection and quantification of exhaled volatile organic compounds in mechanically ventilated patients - comparison of two sampling methods |
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