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

作者：Schnabel Ronny; Fijten Rianne; Smolinska Agnieszka; Dallinga Jan; Boumans Marie Louise; Stobberingh Ellen; Boots Agnes; Roekaerts Paul; Bergmans Dennis; van Schooten Frederik Jan

来源：Scientific Reports, 2015, 5(1): 17179.

DOI：10.1038/srep17179

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.

• 出版日期2015-11-26