Moderne Atemgasanalysen

Wirtz, Lina; Kreuer, Sascha; Volk, Thomas; Hüppe, Tobias

doi:10.1007/s00063-019-0544-0

Cited by 5 publications

(4 citation statements)

References 38 publications

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“…Multicapillary column–ion mobility spectrometry (MCC–IMS) has been used to examine exhaled volatile organic compounds [ 18 , 19 , 20 ] and monitor exhaled propofol [ 21 , 22 , 23 ] in ventilated patients. However, volatile aldehydes are typically exhaled at concentrations of a few parts per billion [ 24 , 25 ], which raises the question of whether the MCC–IMS technique with our corresponding sampling setup is sensitive enough to quantify exhaled aldehydes.…”

Section: Introductionmentioning

confidence: 99%

Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients

et al. 2021

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Exhaled aliphatic aldehydes were proposed as non-invasive biomarkers to detect increased lipid peroxidation in various diseases. As a prelude to clinical application of the multicapillary column–ion mobility spectrometry for the evaluation of aldehyde exhalation, we, therefore: (1) identified the most abundant volatile aliphatic aldehydes originating from in vitro oxidation of various polyunsaturated fatty acids; (2) evaluated emittance of aldehydes from plastic parts of the breathing circuit; (3) conducted a pilot study for in vivo quantification of exhaled aldehydes in mechanically ventilated patients. Pentanal, hexanal, heptanal, and nonanal were quantifiable in the headspace of oxidizing polyunsaturated fatty acids, with pentanal and hexanal predominating. Plastic parts of the breathing circuit emitted hexanal, octanal, nonanal, and decanal, whereby nonanal and decanal were ubiquitous and pentanal or heptanal not being detected. Only pentanal was quantifiable in breath of mechanically ventilated surgical patients with a mean exhaled concentration of 13 ± 5 ppb. An explorative analysis suggested that pentanal exhalation is associated with mechanical power—a measure for the invasiveness of mechanical ventilation. In conclusion, exhaled pentanal is a promising non-invasive biomarker for lipid peroxidation inducing pathologies, and should be evaluated in future clinical studies, particularly for detection of lung injury.

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Section: Introductionmentioning

confidence: 99%

Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients

et al. 2021

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“…15 The first three are reported to be not suitable in the operating room due to their large instrument size, loud operating noise and complex operation. 16 In studies using GC-SAW, exhaled breath was collected offline, which may have resulted in the loss of important drug concentration information. 17 The performance of IMS is easily disturbed by humidity, which is high in exhaled breath.…”

Section: Discussionmentioning

confidence: 99%

“…The reason why the concentration of ciprofol in expired air is so low, in our opinion, is related to the saturated vapor pressure of ciprofol. 16 The volatility of a substance is related to its saturated vapor pressure, which is lower for propofol. 19 Like propofol, ciprofol is more lipid soluble, and less volatile gas is formed from free ciprofol in the blood and passes through the alveolar membrane.…”

Section: Discussionmentioning

confidence: 99%

Calibration and validation of ultraviolet time-of-flight mass spectrometry for online measurement of exhaled ciprofol

Chen

Xing

et al. 2023

Anal. Methods

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“…Dead space ventilation, minute ventilation and fresh gas flow can influence the exP concentration. This may limit its accuracy in some clinical settings [ 16 ]. Still, we do not believe that this had a relevant impact in our study: The lower correlation in this study compared to adult studies may be explained by the fact that we compared exP with calculated propofol concentrations using pharmacokinetic models.…”

Section: Discussionmentioning

confidence: 99%

Correlation of exhaled propofol with Narcotrend index and calculated propofol plasma levels in children undergoing surgery under total intravenous anesthesia - an observational study

et al. 2021

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Background Exhaled propofol concentrations correlate with propofol concentrations in adult human blood and the brain tissue of rats, as well as with electroencephalography (EEG) based indices of anesthetic depth. The pharmacokinetics of propofol are however different in children compared to adults. The value of exhaled propofol measurements in pediatric anesthesia has not yet been investigated. Breathing system filters and breathing circuits can also interfere with the measurements. In this study, we investigated correlations between exhaled propofol (exP) concentrations and the Narkotrend Index (NI) as well as calculated propofol plasma concentrations. Methods A multi-capillary-column (MCC) combined with ion mobility spectrometry (IMS) was used to determine exP. Optimal positioning of breathing system filters (near-patient or patient-distant) and sample line (proximal or distal to filter) were investigated. Measurements were taken during induction (I), maintenance (M) and emergence (E) of children under total intravenous anesthesia (TIVA). Correlations between ExP concentrations and NI and predicted plasma propofol concentrations (using pediatric pharmacokinetic models Kataria and Paedfusor) were assessed using Pearson correlation and regression analysis. Results Near-patient positioning of breathing system filters led to continuously rising exP values when exP was measured proximal to the filters, and lower concentrations when exP was measured distal to the filters. The breathing system filters were therefore subsequently attached between the breathing system tubes and the inspiratory and expiratory limbs of the anesthetic machine. ExP concentrations significantly correlated with NI and propofol concentrations predicted by pharmacokinetic models during induction and maintenance of anesthesia. During emergence, exP significantly correlated with predicted propofol concentrations, but not with NI. Conclusion In this study, we demonstrated that exP correlates with calculated propofol concentrations and NI during induction and maintenance in pediatric patients. However, the correlations are highly variable and there are substantial obstacles: Without patient proximal placement of filters, the breathing circuit tubing must be changed after each patient, and furthermore, during ventilation, a considerable additional loss of heat and moisture can occur. Adhesion of propofol to plastic parts (endotracheal tube, breathing circle) may especially be problematic during emergence. Trial Registration The study was registered in the German registry of clinical studies (DRKS-ID: DRKS00015795).

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Moderne Atemgasanalysen

Cited by 5 publications

References 38 publications

Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients

Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients

Calibration and validation of ultraviolet time-of-flight mass spectrometry for online measurement of exhaled ciprofol

Correlation of exhaled propofol with Narcotrend index and calculated propofol plasma levels in children undergoing surgery under total intravenous anesthesia - an observational study

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