Use of the ReCIVA device in breath sampling of patients with acute breathlessness: a feasibility study

Abstract

IntroductionInvestigating acute multifactorial undifferentiated breathlessness and understanding the driving inflammatory processes can be technically challenging in both adults and children. Being able to validate noninvasive methods such as breath analysis would be a huge clinical advance. The ReCIVA® device allows breath samples to be collected directly onto sorbent tubes at the bedside for analysis of exhaled volatile organic compounds (eVOCs). We aimed to assess the feasibility of using this device in acutely breathless patients.MethodsAdults hospitalised with acute breathlessness and children aged 5–16 years with acute asthma or chronic stable asthma, as well as healthy adult and child volunteers, were recruited. Breath samples were collected onto sorbent tubes using the ReCIVA® device and sent for analysis by means of two-dimensional gas chromatography-mass spectrometry (GCxGC-MS). The NASA Task Load Index (NASA-TLX) was used to assess the perceived task workload of undertaking sampling from the patient's perspective.ResultsData were available for 65 adults and 61 children recruited. In total, 98.4% of adults and 75.4% of children were able to provide the full target breath sample using the ReCIVA® device. NASA-TLX measurements were available in the adult population with mean values of 3.37 for effort, 2.34 for frustration, 3.8 for mental demand, 2.8 for performance, 3.9 for physical demand and 2.8 for temporal demand.DiscussionThis feasibility study demonstrates it is possible and acceptable to collect breath samples from both adults and children at the bedside for breathomics analysis using the ReCIVA® device.

Visualization of exhaled breath metabolites reveals distinct diagnostic signatures for acute cardiorespiratory breathlessness

“…Participants’ demographic and clinical characteristics are summarised in ( Table 1 ). Breath samples were collected using a ReCIVA device, adopting a standardised sampling and gated protocol that enriches alveolar volatiles ( 6 ), and analysed using thermal desorption (TD) coupled to comprehensive two-dimensional gas chromatography (GCxGC) with dual flame ionisation detection (FID) and mass spectrometry (MS).…”

“…Exhaled breath collection was attempted in all consented participants using a CE marked breath sampling device ’Respiration Collector for In Vitro Analysis’ RECIVA (Owlstone Nanotech Ltd), in combination with a dedicated clean air supply unit ( 26 ). Breath sampling was well tolerated by all participants ( 6 ).…”

A systematic review of the diagnostic accuracy of volatile organic compounds in airway diseases and their relation to markers of type-2 inflammation

“…The review has highlighted a wide range of breath collection and analysis technologies, with promising advances in sampling such as the development of the breath gated ReCIVA device [ 45 , 46 ] and novel analytical methodologies applied to breath, such as GCxGC-MS, that may offer superior sensitivity in volatile metabolite identification [ 15 ]. Standardised protocols will need to be carefully designed to accommodate the emerging methodologies.…”

Millimeter-wave gas spectroscopy for breath analysis of COPD patients in comparison to GC-MS

“…For most investigated species, the measured abundances cover roughly one order of magnitude, which is well suited for a comparison between the methods. The samples were taken with the ReCIVA sampler from Owlstone Medical Ltd according to the respective protocol of the study [44,46]. It is a handheld device with integrated pumps, pressure sensor and carbon dioxide sensor to allow for a controlled sampling of VOCs from exhaled breath.…”