Surveillance for lower airway pathogens in mechanically ventilated patients by metabolomic analysis of exhaled breath: a case-control study

Abstract

Breath volatile analysis is able to classify breath profiles of patients with and without significant pathogen load in the lower respiratory tract. If validated in independent cohorts, these findings could lead to development of rapid non-invasive point-of-care surveillance systems and diagnostics for lower respiratory tract infection in the intensive care unit.

What’s new in ventilator-associated pneumonia?

“…Molecular diagnostic tools, metabolomics, and proteomics using an ''artificial nose'' are areas of promising research [11]. Indeed, a ''personalized approach'' in management of patients with ventilator-associated respiratory infections is required [12].…”

BreathDx – molecular analysis of exhaled breath as a diagnostic test for ventilator–associated pneumonia: protocol for a European multicentre observational study

“…Exhaled VOC profiles have been shown to differentiate between many different disease states and may therefore qualify as non-invasive biomarkers [18][19][20][21]. Capture of VOCs and exhaled breath analysis has proven to be safe and reliable in mechanically ventilated critically ill patients [22][23][24]. Data from in-vitro experiments suggest that the presence of bacteria may be detected based on a small panel of VOCs [17].…”

“…Data from in-vitro experiments suggest that the presence of bacteria may be detected based on a small panel of VOCs [17]. This concept was recently translated in vivo: ventilated patients with and without positive bacterial cultures of endotracheal aspirate could be discriminated based on exhaled VOCs [24].…”

Noninvasive Metabolic Profiling for Painless Diagnosis of Human Diseases and Disorders

“…Metabolic profiling of breath VOCs has been utilized to separate breath metabolite patterns of patients with and without lower respiratory tract infections thus exhibiting its diagnostic potential in respiratory tract infections [97]. …”

“…For the implementation of metabolic profiling as a nonnvasive diagnostic tool in clinical practices large scale prospective clinical studies are required in distant future. The main thrust areas involve diseases such as IBD [43], hepatitis C virus infection [44], depression associated with hepatitis B virus-infected patients [45], neurodegenerative disorders [66], ARDS [76], pleural mesothelioma [95], respiratory tract infections [97], nonalcoholic fatty liver disease [110,111] and rheumatic diseases [49]. …”