Exhaled Breath Condensate Biomarkers in Critically Ill, Mechanically Ventilated Patients

Overview

Journal J Breath Res

Specialty Pulmonary Medicine

Date 2020 Oct 16

PMID 33065557

Citations 1

Authors

Michael D Davis

Brett R Winters

Michael C Madden

Joachim D Pleil

Curtis N Sessler

M Ariel Geer Wallace

Cavin K Ward-Caviness

Alison J Montpetit

Affiliations

Soon will be listed here.

Abstract

Pneumonia is a significant risk for critically ill, mechanically ventilated (CIMV) patients. Diagnosis of pneumonia generally requires a combination of clinician-guided diagnoses and clinical scoring systems. Exhaled breath condensate (EBC) can be safely collected non-invasively from CIMV patients. Hundreds of biomarkers in EBC are associated with acute disease states, including pneumonia. We evaluated cytokines in EBC from CIMV patients and hypothesized that these biomarkers would correlate with disease severity in pneumonia, sepsis, and death. EBC IL-2 levels were associated with chest radiograph severity scores (odds ratio = 1.68; 95% confidence interval = 1.09-2.60; P = 0.02). EBC TNF-α levels were also associated with pneumonia (odds ratio = 3.20; 95% confidence interval = 1.19-8.65; P = 0.02). The techniques and results from this study may be useful for all mechanically ventilated patients.

Citing Articles

A Concise Review of Exhaled Breath Testing for Respiratory Clinicians and Researchers.

Wang R, Davis M Respir Care. 2024; 69(5):613-620.

PMID: 38199760 PMC: 11147617. DOI: 10.4187/respcare.11651.

References

Vaschetto R, Corradi M, Goldoni M, Cancelliere L, Pulvirenti S, Fazzini U . Sampling and analyzing alveolar exhaled breath condensate in mechanically ventilated patients: a feasibility study. J Breath Res. 2015; 9(4):047106. DOI: 10.1088/1752-7155/9/4/047106. View

Balci C, Sungurtekin H, Gurses E, Sungurtekin U, Kaptanoglu B . Usefulness of procalcitonin for diagnosis of sepsis in the intensive care unit. Crit Care. 2003; 7(1):85-90. PMC: 154110. DOI: 10.1186/cc1843. View

Carter S, Davis C, Kovacs E . Exhaled breath condensate collection in the mechanically ventilated patient. Respir Med. 2012; 106(5):601-13. PMC: 3314159. DOI: 10.1016/j.rmed.2012.02.003. View

. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med. 2005; 171(4):388-416. DOI: 10.1164/rccm.200405-644ST. View

Heyland D, Cook D, Griffith L, Keenan S, Brun-Buisson C . The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am J Respir Crit Care Med. 1999; 159(4 Pt 1):1249-56. DOI: 10.1164/ajrccm.159.4.9807050. View

Konstantinidi E, Lappas A, Tzortzi A, Behrakis P . Exhaled Breath Condensate: Technical and Diagnostic Aspects. ScientificWorldJournal. 2015; 2015:435160. PMC: 4461795. DOI: 10.1155/2015/435160. View

Kuban P, Foret F . Exhaled breath condensate: determination of non-volatile compounds and their potential for clinical diagnosis and monitoring. A review. Anal Chim Acta. 2013; 805:1-18. DOI: 10.1016/j.aca.2013.07.049. View

Walsh B, Mackey D, Pajewski T, Yu Y, Gaston B, Hunt J . Exhaled-breath condensate pH can be safely and continuously monitored in mechanically ventilated patients. Respir Care. 2006; 51(10):1125-31. View

Wang C, Tang R, Chung R, Hwang B . Tumor necrosis factor-alpha and interleukin-6 profiles in children with pneumonia. J Microbiol Immunol Infect. 2000; 32(4):233-8. View

10.

Davis M, Montpetit A . Exhaled Breath Condensate: An Update. Immunol Allergy Clin North Am. 2018; 38(4):667-678. DOI: 10.1016/j.iac.2018.06.002. View

11.

Bregeon F, Delpierre S, Chetaille B, Kajikawa O, Martin T, Autillo-Touati A . Mechanical ventilation affects lung function and cytokine production in an experimental model of endotoxemia. Anesthesiology. 2005; 102(2):331-9. DOI: 10.1097/00000542-200502000-00015. View

12.

Antcliffe D, Wolfer A, ODea K, Takata M, Holmes E, Gordon A . Profiling inflammatory markers in patients with pneumonia on intensive care. Sci Rep. 2018; 8(1):14736. PMC: 6170441. DOI: 10.1038/s41598-018-32938-6. View

13.

Li Bassi G, Guillamat Prats R, Artigas A, Aguilera Xiol E, Marti J, Ranzani O . Appraisal of systemic inflammation and diagnostic markers in a porcine model of VAP: secondary analysis from a study on novel preventive strategies. Intensive Care Med Exp. 2018; 6(1):42. PMC: 6195872. DOI: 10.1186/s40635-018-0206-1. View

14.

Rynda-Apple A, Harmsen A, Erickson A, Larson K, Morton R, Richert L . Regulation of IFN-γ by IL-13 dictates susceptibility to secondary postinfluenza MRSA pneumonia. Eur J Immunol. 2014; 44(11):3263-72. PMC: 4237004. DOI: 10.1002/eji.201444582. View

15.

Goldoni M, Corradi M, Mozzoni P, Folesani G, Alinovi R, Pinelli S . Concentration of exhaled breath condensate biomarkers after fractionated collection based on exhaled CO2 signal. J Breath Res. 2013; 7(1):017101. DOI: 10.1088/1752-7155/7/1/017101. View

16.

Kurt A, Aygun A, Godekmerdan A, Kurt A, Dogan Y, Yilmaz E . Serum IL-1beta, IL-6, IL-8, and TNF-alpha levels in early diagnosis and management of neonatal sepsis. Mediators Inflamm. 2008; 2007:31397. PMC: 2220039. DOI: 10.1155/2007/31397. View

17.

Pugin J . Clinical signs and scores for the diagnosis of ventilator-associated pneumonia. Minerva Anestesiol. 2002; 68(4):261-5. View

18.

Swanson J, Mueller E, Croce M, Wood G, Boucher B, Magnotti L . Changes in pulmonary cytokines during antibiotic therapy for ventilator-associated pneumonia. Surg Infect (Larchmt). 2009; 11(2):161-7. DOI: 10.1089/sur.2008.067. View

19.

Schulte W, Bernhagen J, Bucala R . Cytokines in sepsis: potent immunoregulators and potential therapeutic targets--an updated view. Mediators Inflamm. 2013; 2013:165974. PMC: 3703895. DOI: 10.1155/2013/165974. View

20.

Papazian L, Klompas M, Luyt C . Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020; 46(5):888-906. PMC: 7095206. DOI: 10.1007/s00134-020-05980-0. View