Exhaled Breath and Oxygenator Sweep Gas Propionaldehyde in Acute Respiratory Distress Syndrome.


Journal

Molecules (Basel, Switzerland)
ISSN: 1420-3049
Titre abrégé: Molecules
Pays: Switzerland
ID NLM: 100964009

Informations de publication

Date de publication:
31 Dec 2020
Historique:
received: 07 12 2020
revised: 21 12 2020
accepted: 23 12 2020
entrez: 5 1 2021
pubmed: 6 1 2021
medline: 14 4 2021
Statut: epublish

Résumé

Oxidative stress-induced lipid peroxidation (LPO) due to neutrophil-derived reactive oxygen species plays a key role in the early stage of the acute respiratory distress syndrome (ARDS). Monitoring of oxidative stress in this patient population is of great interest, and, ideally, this can be done noninvasively. Recently, propionaldehyde, a volatile chemical compound (VOC) released during LPO, was identified in the breath of lung transplant recipients as a marker of oxidative stress. The aim of the present study was to identify if markers of oxidative stress appear in the oxygenator outflow gas of patients with severe ARDS treated with veno-venous extracorporeal membrane oxygenation (ECMO). The present study included patients with severe ARDS treated with veno-venous ECMO. Concentrations of acetone, isoprene, and propionaldehyde were measured in inspiratory air, exhaled breath, and oxygenator inflow and outflow gas at corresponding time points. Ion-molecule reaction mass spectrometry was used to measure VOCs in a sequential order within the first 24 h and on day three after ECMO initiation. Nine patients (5 female, 4 male; age = 42.1 ± 12.2 year) with ARDS and already established ECMO therapy (pre-ECMO PaO Acetone, isoprene, and propionaldehyde appear in breath and oxygenator outflow gas in comparable amounts. This allows for the measurement of these VOCs in a critically ill patient population via the ECMO oxygenator outflow gas without the need of ventilator circuit manipulation.

Sections du résumé

BACKGROUND BACKGROUND
Oxidative stress-induced lipid peroxidation (LPO) due to neutrophil-derived reactive oxygen species plays a key role in the early stage of the acute respiratory distress syndrome (ARDS). Monitoring of oxidative stress in this patient population is of great interest, and, ideally, this can be done noninvasively. Recently, propionaldehyde, a volatile chemical compound (VOC) released during LPO, was identified in the breath of lung transplant recipients as a marker of oxidative stress. The aim of the present study was to identify if markers of oxidative stress appear in the oxygenator outflow gas of patients with severe ARDS treated with veno-venous extracorporeal membrane oxygenation (ECMO).
METHODS METHODS
The present study included patients with severe ARDS treated with veno-venous ECMO. Concentrations of acetone, isoprene, and propionaldehyde were measured in inspiratory air, exhaled breath, and oxygenator inflow and outflow gas at corresponding time points. Ion-molecule reaction mass spectrometry was used to measure VOCs in a sequential order within the first 24 h and on day three after ECMO initiation.
RESULTS RESULTS
Nine patients (5 female, 4 male; age = 42.1 ± 12.2 year) with ARDS and already established ECMO therapy (pre-ECMO PaO
CONCLUSIONS CONCLUSIONS
Acetone, isoprene, and propionaldehyde appear in breath and oxygenator outflow gas in comparable amounts. This allows for the measurement of these VOCs in a critically ill patient population via the ECMO oxygenator outflow gas without the need of ventilator circuit manipulation.

Identifiants

pubmed: 33396196
pii: molecules26010145
doi: 10.3390/molecules26010145
pmc: PMC7796205
pii:
doi:

Substances chimiques

Aldehydes 0
propionaldehyde AMJ2B4M67V

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Federal Ministry of Economics and Technology
ID : 50WB0719, 50WB0919
Organisme : European Space Agency
ID : ELIPS 3 programme

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Auteurs

Agnes S Meidert (AS)

Department of Anesthesiology, University Hospital of Munich-Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany.

Alexander Choukèr (A)

Department of Anesthesiology, University Hospital of Munich-Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany.

Siegfried Praun (S)

V&F Analyse-und Messtechnik GmbH, Andreas Hofer Strasse 15, 6067 Absam, Austria.

Gustav Schelling (G)

Department of Anesthesiology, University Hospital of Munich-Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany.

Michael E Dolch (ME)

Department of Anesthesiology, University Hospital of Munich-Campus Großhadern, Ludwig-Maximilians-University of Munich, 81366 Munich, Germany.
Department of Anesthesiology & Intensive Care Medicine, InnKlinikum Altötting, Vinzenz-von-Paul-Str. 10, 84503 Altötting, Germany.

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Classifications MeSH