Breath metabolite response to major upper gastrointestinal surgery
Abstract Background Esophagectomy and gastrectomy are associated with profound metabolic changes and significant postoperative morbidity. The aim of this prospective clinical study was to determine whether breath analysis can offer novel insight into the surgical metabolic response and identify biom...
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| Veröffentlicht in: | The Journal of surgical research 2015-02, Vol.193 (2), p.704-712 |
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| creator | Boshier, Piers R., PhD Mistry, Vikash, MBBS Cushnir, Julia R., PhD Kon, Onn Min, FRCP Elkin, Sarah L., FRCP Curtis, Sally, FRCPath Marczin, Nandor, MD, PhD Hanna, George B., FRCS |
| description | Abstract Background Esophagectomy and gastrectomy are associated with profound metabolic changes and significant postoperative morbidity. The aim of this prospective clinical study was to determine whether breath analysis can offer novel insight into the surgical metabolic response and identify biomarkers of postoperative complications, including lung injury. Methods Breath samples were collected preoperatively and at 24, 48, 72, 96 and 168 h after esophagectomy ( n = 25) and gastrectomy ( n = 15). Targeted analysis of four prominent breath metabolites was performed by selected ion flow-tube mass spectrometry. Patients with nonsurgical lung injury (community-acquired pneumonia) were recruited as positive controls. Results Perioperative starvation and subsequent reintroduction of nutritional input were associated with significant changes in breath acetone levels. Breath acetone levels fell after esophagectomy ( P = 0.008) and were significantly lower than in gastrectomy patients at postoperative time points 48 ( P |
| doi_str_mv | 10.1016/j.jss.2014.09.004 |
| format | Article |
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The aim of this prospective clinical study was to determine whether breath analysis can offer novel insight into the surgical metabolic response and identify biomarkers of postoperative complications, including lung injury. Methods Breath samples were collected preoperatively and at 24, 48, 72, 96 and 168 h after esophagectomy ( n = 25) and gastrectomy ( n = 15). Targeted analysis of four prominent breath metabolites was performed by selected ion flow-tube mass spectrometry. Patients with nonsurgical lung injury (community-acquired pneumonia) were recruited as positive controls. Results Perioperative starvation and subsequent reintroduction of nutritional input were associated with significant changes in breath acetone levels. Breath acetone levels fell after esophagectomy ( P = 0.008) and were significantly lower than in gastrectomy patients at postoperative time points 48 ( P < 0.001) and 72 h ( P < 0.001). In contrast, concentrations of isoprene increased significantly after esophagectomy ( P = 0.014). Pneumonia was the most frequently observed postoperative complication (esophagectomy 36% and gastrectomy 7%). The concentration of hydrogen cyanide was significantly lower in the breath of patients who developed pneumonia, 72 h after surgery ( P = 0.008). Exhaled hydrogen cyanide ( P = 0.001) and isoprene ( P = 0.014) were also reduced in patients with community-acquired pneumonia compared with healthy controls. Conclusions Selected ion flow-tube mass spectrometry can be used as a totally noninvasive resource to monitor multiple aspects of metabolic alterations in the postoperative period. Exhaled concentrations of several prominent metabolites are significantly altered after major upper gastrointestinal surgery and in response to pneumonia.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2014.09.004</identifier><identifier>PMID: 25282400</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acetic Acid - analysis ; Acetone - analysis ; Aged ; Breath Tests ; Butadienes - analysis ; Esophagectomy ; Exhaled breath ; Female ; Gastrectomy ; Hemiterpenes - analysis ; Humans ; Hydrogen Cyanide - analysis ; Male ; Mass Spectrometry ; Metabolism ; Middle Aged ; Nutritional Status ; Oxidative Stress ; Pentanes - analysis ; Perioperative Period ; Pneumonia ; Postoperative Complications - diagnosis ; Postoperative Complications - metabolism ; Prospective Studies ; Selective ion flow tube mass spectrometry ; Surgery</subject><ispartof>The Journal of surgical research, 2015-02, Vol.193 (2), p.704-712</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-42e496a09e42d598bfab67a11b8b02c13b7fade9e2e925fed7b39b08940babe43</citedby><cites>FETCH-LOGICAL-c474t-42e496a09e42d598bfab67a11b8b02c13b7fade9e2e925fed7b39b08940babe43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2014.09.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25282400$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boshier, Piers R., PhD</creatorcontrib><creatorcontrib>Mistry, Vikash, MBBS</creatorcontrib><creatorcontrib>Cushnir, Julia R., PhD</creatorcontrib><creatorcontrib>Kon, Onn Min, FRCP</creatorcontrib><creatorcontrib>Elkin, Sarah L., FRCP</creatorcontrib><creatorcontrib>Curtis, Sally, FRCPath</creatorcontrib><creatorcontrib>Marczin, Nandor, MD, PhD</creatorcontrib><creatorcontrib>Hanna, George B., FRCS</creatorcontrib><title>Breath metabolite response to major upper gastrointestinal surgery</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>Abstract Background Esophagectomy and gastrectomy are associated with profound metabolic changes and significant postoperative morbidity. The aim of this prospective clinical study was to determine whether breath analysis can offer novel insight into the surgical metabolic response and identify biomarkers of postoperative complications, including lung injury. Methods Breath samples were collected preoperatively and at 24, 48, 72, 96 and 168 h after esophagectomy ( n = 25) and gastrectomy ( n = 15). Targeted analysis of four prominent breath metabolites was performed by selected ion flow-tube mass spectrometry. Patients with nonsurgical lung injury (community-acquired pneumonia) were recruited as positive controls. Results Perioperative starvation and subsequent reintroduction of nutritional input were associated with significant changes in breath acetone levels. Breath acetone levels fell after esophagectomy ( P = 0.008) and were significantly lower than in gastrectomy patients at postoperative time points 48 ( P < 0.001) and 72 h ( P < 0.001). In contrast, concentrations of isoprene increased significantly after esophagectomy ( P = 0.014). Pneumonia was the most frequently observed postoperative complication (esophagectomy 36% and gastrectomy 7%). The concentration of hydrogen cyanide was significantly lower in the breath of patients who developed pneumonia, 72 h after surgery ( P = 0.008). Exhaled hydrogen cyanide ( P = 0.001) and isoprene ( P = 0.014) were also reduced in patients with community-acquired pneumonia compared with healthy controls. Conclusions Selected ion flow-tube mass spectrometry can be used as a totally noninvasive resource to monitor multiple aspects of metabolic alterations in the postoperative period. Exhaled concentrations of several prominent metabolites are significantly altered after major upper gastrointestinal surgery and in response to pneumonia.</description><subject>Acetic Acid - analysis</subject><subject>Acetone - analysis</subject><subject>Aged</subject><subject>Breath Tests</subject><subject>Butadienes - analysis</subject><subject>Esophagectomy</subject><subject>Exhaled breath</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Hemiterpenes - analysis</subject><subject>Humans</subject><subject>Hydrogen Cyanide - analysis</subject><subject>Male</subject><subject>Mass Spectrometry</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Nutritional Status</subject><subject>Oxidative Stress</subject><subject>Pentanes - analysis</subject><subject>Perioperative Period</subject><subject>Pneumonia</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - metabolism</subject><subject>Prospective Studies</subject><subject>Selective ion flow tube mass spectrometry</subject><subject>Surgery</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-L1jAQxoMo7uvqB_AiPXppnaTpnyAI7qK7woIH9RySdLqmtk3NpML77c3Lu3rw4GkYeJ5nZn7D2EsOFQfevpmqiagSwGUFqgKQj9iBg2rKvu3qx-wAIEQpe5AX7BnRBLlXXf2UXYhG9EICHNjVVUSTvhcLJmPD7BMWEWkLK2GRQrGYKcRi3zaMxb2hFINfE1Lyq5kL2uM9xuNz9mQ0M-GLh3rJvn388PX6trz7fPPp-v1d6WQnUykFStUaUCjF0Kjejsa2neHc9haE47XtRjOgQoFKNCMOna2VhV5JsMairC_Z63PuFsPPPS-hF08O59msGHbSvK27pmn6RmQpP0tdDEQRR71Fv5h41Bz0CZ2edEanT-g0KJ3RZc-rh_jdLjj8dfxhlQVvzwLMR_7yGDU5j6vDwUd0SQ_B_zf-3T9uN_vVOzP_wCPSFPaYmeYrNAkN-svpd6fX8Ty6zxvUvwGtVpS1</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Boshier, Piers R., PhD</creator><creator>Mistry, Vikash, MBBS</creator><creator>Cushnir, Julia R., PhD</creator><creator>Kon, Onn Min, FRCP</creator><creator>Elkin, Sarah L., FRCP</creator><creator>Curtis, Sally, FRCPath</creator><creator>Marczin, Nandor, MD, PhD</creator><creator>Hanna, George B., FRCS</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>Breath metabolite response to major upper gastrointestinal surgery</title><author>Boshier, Piers R., PhD ; Mistry, Vikash, MBBS ; Cushnir, Julia R., PhD ; Kon, Onn Min, FRCP ; Elkin, Sarah L., FRCP ; Curtis, Sally, FRCPath ; Marczin, Nandor, MD, PhD ; Hanna, George B., FRCS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-42e496a09e42d598bfab67a11b8b02c13b7fade9e2e925fed7b39b08940babe43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acetic Acid - analysis</topic><topic>Acetone - analysis</topic><topic>Aged</topic><topic>Breath Tests</topic><topic>Butadienes - analysis</topic><topic>Esophagectomy</topic><topic>Exhaled breath</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Hemiterpenes - analysis</topic><topic>Humans</topic><topic>Hydrogen Cyanide - analysis</topic><topic>Male</topic><topic>Mass Spectrometry</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Nutritional Status</topic><topic>Oxidative Stress</topic><topic>Pentanes - analysis</topic><topic>Perioperative Period</topic><topic>Pneumonia</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - metabolism</topic><topic>Prospective Studies</topic><topic>Selective ion flow tube mass spectrometry</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boshier, Piers R., PhD</creatorcontrib><creatorcontrib>Mistry, Vikash, MBBS</creatorcontrib><creatorcontrib>Cushnir, Julia R., PhD</creatorcontrib><creatorcontrib>Kon, Onn Min, FRCP</creatorcontrib><creatorcontrib>Elkin, Sarah L., FRCP</creatorcontrib><creatorcontrib>Curtis, Sally, FRCPath</creatorcontrib><creatorcontrib>Marczin, Nandor, MD, PhD</creatorcontrib><creatorcontrib>Hanna, George B., FRCS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boshier, Piers R., PhD</au><au>Mistry, Vikash, MBBS</au><au>Cushnir, Julia R., PhD</au><au>Kon, Onn Min, FRCP</au><au>Elkin, Sarah L., FRCP</au><au>Curtis, Sally, FRCPath</au><au>Marczin, Nandor, MD, PhD</au><au>Hanna, George B., FRCS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Breath metabolite response to major upper gastrointestinal surgery</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>193</volume><issue>2</issue><spage>704</spage><epage>712</epage><pages>704-712</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><abstract>Abstract Background Esophagectomy and gastrectomy are associated with profound metabolic changes and significant postoperative morbidity. The aim of this prospective clinical study was to determine whether breath analysis can offer novel insight into the surgical metabolic response and identify biomarkers of postoperative complications, including lung injury. Methods Breath samples were collected preoperatively and at 24, 48, 72, 96 and 168 h after esophagectomy ( n = 25) and gastrectomy ( n = 15). Targeted analysis of four prominent breath metabolites was performed by selected ion flow-tube mass spectrometry. Patients with nonsurgical lung injury (community-acquired pneumonia) were recruited as positive controls. Results Perioperative starvation and subsequent reintroduction of nutritional input were associated with significant changes in breath acetone levels. Breath acetone levels fell after esophagectomy ( P = 0.008) and were significantly lower than in gastrectomy patients at postoperative time points 48 ( P < 0.001) and 72 h ( P < 0.001). In contrast, concentrations of isoprene increased significantly after esophagectomy ( P = 0.014). Pneumonia was the most frequently observed postoperative complication (esophagectomy 36% and gastrectomy 7%). The concentration of hydrogen cyanide was significantly lower in the breath of patients who developed pneumonia, 72 h after surgery ( P = 0.008). Exhaled hydrogen cyanide ( P = 0.001) and isoprene ( P = 0.014) were also reduced in patients with community-acquired pneumonia compared with healthy controls. Conclusions Selected ion flow-tube mass spectrometry can be used as a totally noninvasive resource to monitor multiple aspects of metabolic alterations in the postoperative period. Exhaled concentrations of several prominent metabolites are significantly altered after major upper gastrointestinal surgery and in response to pneumonia.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25282400</pmid><doi>10.1016/j.jss.2014.09.004</doi><tpages>9</tpages></addata></record> |
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| subjects | Acetic Acid - analysis Acetone - analysis Aged Breath Tests Butadienes - analysis Esophagectomy Exhaled breath Female Gastrectomy Hemiterpenes - analysis Humans Hydrogen Cyanide - analysis Male Mass Spectrometry Metabolism Middle Aged Nutritional Status Oxidative Stress Pentanes - analysis Perioperative Period Pneumonia Postoperative Complications - diagnosis Postoperative Complications - metabolism Prospective Studies Selective ion flow tube mass spectrometry Surgery |
| title | Breath metabolite response to major upper gastrointestinal surgery |
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