Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia

R. Schnabel, R. Fijten, A. Smolinska, Jan Dallinga, M.L. Boumans, E. Stobberingh, Agnes Boots, P. Roekaerts, D. Bergmans, Frederik Jan van Schooten

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)

Abstract

Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard is based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive method for rapid diagnosis of diseases and contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. The aim of this study was to determine whether analysis of VOCs in exhaled breath can be used as a non-invasive monitoring tool for VAP. One hundred critically ill patients with clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were collected and analysed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients [VAP(-)]. Multivariate statistical comparison of VOC profiles between VAP(+) and VAP(-) revealed a subset of 12 VOCs that correctly discriminated between those two patient groups with a sensitivity and specificity of 75.8% +/- 13.5% and 73.0% +/- 11.8%, respectively. These results suggest that detection of VAP in ICU patients is possible by examining exhaled breath, enabling a simple, safe and non-invasive approach that could diminish diagnostic burden of VAP.
Original languageEnglish
Article number17179
Number of pages10
JournalScientific Reports
Volume5
DOIs
Publication statusPublished - 26 Nov 2015

Keywords

  • BRONCHOALVEOLAR LAVAGE FLUID
  • ELECTRONIC-NOSE
  • METABOLISM
  • METABOLOMICS
  • TOOL
  • ETHYLBENZENE
  • INFORMATION
  • RELEVANT
  • DISEASE
  • PROTEIN

Cite this

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title = "Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia",
abstract = "Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard is based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive method for rapid diagnosis of diseases and contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. The aim of this study was to determine whether analysis of VOCs in exhaled breath can be used as a non-invasive monitoring tool for VAP. One hundred critically ill patients with clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were collected and analysed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients [VAP(-)]. Multivariate statistical comparison of VOC profiles between VAP(+) and VAP(-) revealed a subset of 12 VOCs that correctly discriminated between those two patient groups with a sensitivity and specificity of 75.8{\%} +/- 13.5{\%} and 73.0{\%} +/- 11.8{\%}, respectively. These results suggest that detection of VAP in ICU patients is possible by examining exhaled breath, enabling a simple, safe and non-invasive approach that could diminish diagnostic burden of VAP.",
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language = "English",
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Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia. / Schnabel, R.; Fijten, R.; Smolinska, A.; Dallinga, Jan; Boumans, M.L.; Stobberingh, E.; Boots, Agnes; Roekaerts, P.; Bergmans, D.; van Schooten, Frederik Jan.

In: Scientific Reports, Vol. 5, 17179, 26.11.2015.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia

AU - Schnabel, R.

AU - Fijten, R.

AU - Smolinska, A.

AU - Dallinga, Jan

AU - Boumans, M.L.

AU - Stobberingh, E.

AU - Boots, Agnes

AU - Roekaerts, P.

AU - Bergmans, D.

AU - van Schooten, Frederik Jan

PY - 2015/11/26

Y1 - 2015/11/26

N2 - Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard is based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive method for rapid diagnosis of diseases and contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. The aim of this study was to determine whether analysis of VOCs in exhaled breath can be used as a non-invasive monitoring tool for VAP. One hundred critically ill patients with clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were collected and analysed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients [VAP(-)]. Multivariate statistical comparison of VOC profiles between VAP(+) and VAP(-) revealed a subset of 12 VOCs that correctly discriminated between those two patient groups with a sensitivity and specificity of 75.8% +/- 13.5% and 73.0% +/- 11.8%, respectively. These results suggest that detection of VAP in ICU patients is possible by examining exhaled breath, enabling a simple, safe and non-invasive approach that could diminish diagnostic burden of VAP.

AB - Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard is based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive method for rapid diagnosis of diseases and contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. The aim of this study was to determine whether analysis of VOCs in exhaled breath can be used as a non-invasive monitoring tool for VAP. One hundred critically ill patients with clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were collected and analysed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients [VAP(-)]. Multivariate statistical comparison of VOC profiles between VAP(+) and VAP(-) revealed a subset of 12 VOCs that correctly discriminated between those two patient groups with a sensitivity and specificity of 75.8% +/- 13.5% and 73.0% +/- 11.8%, respectively. These results suggest that detection of VAP in ICU patients is possible by examining exhaled breath, enabling a simple, safe and non-invasive approach that could diminish diagnostic burden of VAP.

KW - BRONCHOALVEOLAR LAVAGE FLUID

KW - ELECTRONIC-NOSE

KW - METABOLISM

KW - METABOLOMICS

KW - TOOL

KW - ETHYLBENZENE

KW - INFORMATION

KW - RELEVANT

KW - DISEASE

KW - PROTEIN

U2 - 10.1038/srep17179

DO - 10.1038/srep17179

M3 - Article

VL - 5

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

M1 - 17179

ER -