Background
Prompt diagnosis and treatment of acute mesenteric ischemia (AMI) requires a high index of suspicion for timely management. Poor clinical outcomes and delays in surgical treatment are demonstrated even in modern clinical series. Recognition of exhaled volatile organic compounds (VOC’s) specific to AMI may facilitate early detection and diagnosis and improve patient outcomes.
Study Design
Adult Wistar Rats (n=5) were intubated and anesthetized and control tracheostomy breath samples were collected using Tedlar gas sample bags. Intestinal ischemia was induced by placing an occlusive clip across the superior mesenteric artery and breath samples were collected following one hour of intestinal ischemia and following 15 minutes of intestinal reperfusion. Gas chromatography was used to identify and measure levels the VOC’s obtained and measured retention indices were compared with known values in the Kovats Retention Index.
Results
Multiple retention indices (n=41)) were noted on gas chromatography representing a variety of VOC’s detected. Z,Z,-farnesol (C15H26O), an isoprenoid, was the only compound detected which was undetectable during the control phase (median=0 Cts/sec, range=0) but significantly elevated during the ischemic and reperfusion phases(median=34 Cts/sec, range=25–37) and (median=148 Cts/sec. range=42–246), respectively. Three other isoprenoid compounds: E,E-alpha-farnesene, germacrene-A, and Z,Z-4,6,8-megastigmatriene were also detected in all five animals, but their levels did not differ significantly between control, ischemic and reperfusion phases.
Conclusions
This pilot study demonstrates the feasibility of analyzing exhaled VOC’s using a novel rat model for acute mesenteric ischemia. These findings may be useful for the development and identification of similar assays for the rapid diagnosis of acute mesenteric ischemia.