Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients
Background The concentration of exhaled octane has been postulated as a reliable biomarker for acute respiratory distress syndrome (ARDS) using metabolomics analysis with gas chromatography and mass spectrometry (GC-MS). A point-of-care (POC) breath test was developed in recent years to accurately m...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-10-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/5/00214-2023.full |
| _version_ | 1797629347503276032 |
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| author | Laura A. Hagens Nanon F.L. Heijnen Marry R. Smit Alwin R.M. Verschueren Tamara M.E. Nijsen Inge Geven Cristian N. Presură Ronald Rietman Dominic W. Fenn Paul Brinkman Marcus J. Schultz Dennis C.J.J. Bergmans Ronny M. Schnabel Lieuwe D.J. Bos |
| author_facet | Laura A. Hagens Nanon F.L. Heijnen Marry R. Smit Alwin R.M. Verschueren Tamara M.E. Nijsen Inge Geven Cristian N. Presură Ronald Rietman Dominic W. Fenn Paul Brinkman Marcus J. Schultz Dennis C.J.J. Bergmans Ronny M. Schnabel Lieuwe D.J. Bos |
| author_sort | Laura A. Hagens |
| collection | DOAJ |
| description | Background
The concentration of exhaled octane has been postulated as a reliable biomarker for acute respiratory distress syndrome (ARDS) using metabolomics analysis with gas chromatography and mass spectrometry (GC-MS). A point-of-care (POC) breath test was developed in recent years to accurately measure octane at the bedside. The aim of the present study was to validate the diagnostic accuracy of exhaled octane for ARDS using a POC breath test in invasively ventilated intensive care unit (ICU) patients.
Methods
This was an observational cohort study of consecutive patients receiving invasive ventilation for at least 24 h, recruited in two university ICUs. GC-MS and POC breath tests were used to quantify the exhaled octane concentration. ARDS was assessed by three experts following the Berlin definition and used as the reference standard. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic accuracy.
Results
519 patients were included and 190 (37%) fulfilled the criteria for ARDS. The median (interquartile range) concentration of octane using the POC breath test was not significantly different between patients with ARDS (0.14 (0.05–0.37) ppb) and without ARDS (0.11 (0.06–0.26) ppb; p=0.64). The AUC for ARDS based on the octane concentration in exhaled breath using the POC breath test was 0.52 (95% CI 0.46–0.57). Analysis of exhaled octane with GC-MS showed similar results.
Conclusions
Octane in exhaled breath has insufficient diagnostic accuracy for ARDS. This disqualifies the use of octane as a biomarker in the diagnosis of ARDS and challenges most of the research performed up to now in the field of exhaled breath metabolomics. |
| first_indexed | 2024-03-11T10:52:07Z |
| format | Article |
| id | doaj.art-7297dbbe6b1f4db6afe1d13bf2a47664 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-11T10:52:07Z |
| publishDate | 2023-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-7297dbbe6b1f4db6afe1d13bf2a476642023-11-13T14:27:50ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-10-019510.1183/23120541.00214-202300214-2023Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patientsLaura A. Hagens0Nanon F.L. Heijnen1Marry R. Smit2Alwin R.M. Verschueren3Tamara M.E. Nijsen4Inge Geven5Cristian N. Presură6Ronald Rietman7Dominic W. Fenn8Paul Brinkman9Marcus J. Schultz10Dennis C.J.J. Bergmans11Ronny M. Schnabel12Lieuwe D.J. Bos13 Department of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands Department of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands Sleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands Sleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands Sleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands Sleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands Sleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands Department of Respiratory Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands Department of Respiratory Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands Department of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands Department of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands Department of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands Background The concentration of exhaled octane has been postulated as a reliable biomarker for acute respiratory distress syndrome (ARDS) using metabolomics analysis with gas chromatography and mass spectrometry (GC-MS). A point-of-care (POC) breath test was developed in recent years to accurately measure octane at the bedside. The aim of the present study was to validate the diagnostic accuracy of exhaled octane for ARDS using a POC breath test in invasively ventilated intensive care unit (ICU) patients. Methods This was an observational cohort study of consecutive patients receiving invasive ventilation for at least 24 h, recruited in two university ICUs. GC-MS and POC breath tests were used to quantify the exhaled octane concentration. ARDS was assessed by three experts following the Berlin definition and used as the reference standard. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic accuracy. Results 519 patients were included and 190 (37%) fulfilled the criteria for ARDS. The median (interquartile range) concentration of octane using the POC breath test was not significantly different between patients with ARDS (0.14 (0.05–0.37) ppb) and without ARDS (0.11 (0.06–0.26) ppb; p=0.64). The AUC for ARDS based on the octane concentration in exhaled breath using the POC breath test was 0.52 (95% CI 0.46–0.57). Analysis of exhaled octane with GC-MS showed similar results. Conclusions Octane in exhaled breath has insufficient diagnostic accuracy for ARDS. This disqualifies the use of octane as a biomarker in the diagnosis of ARDS and challenges most of the research performed up to now in the field of exhaled breath metabolomics.http://openres.ersjournals.com/content/9/5/00214-2023.full |
| spellingShingle | Laura A. Hagens Nanon F.L. Heijnen Marry R. Smit Alwin R.M. Verschueren Tamara M.E. Nijsen Inge Geven Cristian N. Presură Ronald Rietman Dominic W. Fenn Paul Brinkman Marcus J. Schultz Dennis C.J.J. Bergmans Ronny M. Schnabel Lieuwe D.J. Bos Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients ERJ Open Research |
| title | Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients |
| title_full | Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients |
| title_fullStr | Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients |
| title_full_unstemmed | Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients |
| title_short | Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients |
| title_sort | octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients |
| url | http://openres.ersjournals.com/content/9/5/00214-2023.full |
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