Breath octane and acetaldehyde as markers for acute respiratory distress syndrome in invasively ventilated patients suspected to have ventilator-associated pneumonia
Issued Date
2022-01-01
Resource Type
eISSN
23120541
Scopus ID
2-s2.0-85127670917
Journal Title
ERJ Open Research
Volume
8
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
ERJ Open Research Vol.8 No.1 (2022)
Suggested Citation
Heijnen N.F.L. Breath octane and acetaldehyde as markers for acute respiratory distress syndrome in invasively ventilated patients suspected to have ventilator-associated pneumonia. ERJ Open Research Vol.8 No.1 (2022). doi:10.1183/23120541.00624-2021 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86610
Title
Breath octane and acetaldehyde as markers for acute respiratory distress syndrome in invasively ventilated patients suspected to have ventilator-associated pneumonia
Author(s)
Other Contributor(s)
Abstract
Rationale The concentration of octane and acetaldehyde in exhaled breath has good diagnostic accuracy for acute respiratory distress syndrome (ARDS). We aimed to determine whether breath octane and acetaldehyde are able to distinguish the presence and absence of ARDS in critically ill patients suspected to have ventilator-associated pneumonia (VAP). Methods This is a secondary analysis of a prospective observational study into exhaled breath analysis using gas chromatography–time-of-flight mass spectrometry. Difference in the relative abundance of octane and acetaldehyde in exhaled breath was compared between patients with and without ARDS using the Mann–Whitney U-test and the association was quantified using logistic regression. The discriminative accuracy of octane and acetaldehyde, alone or in combination, was calculated using the area under the receiver operating characteristic curve (AUROCC). Results We included 98 patients, of whom 32 had ARDS and 66 did not. The area under the acetaldehyde peak was higher in patients with ARDS ( p=0.03), and associated with the presence of ARDS (OR 1.06 per 100 000 count change, 95% CI 1.02–1.13 per 100 000 count change; p=0.01). A combined model with octane and acetaldehyde showed a high specificity and low sensitivity (90% and 40.6%, respectively), with a low accuracy (AUROCC 0.65, 95% CI 0.53–0.78). Conclusion Patients suspected to have VAP with ARDS had a higher acetaldehyde concentration in exhaled breath than patients suspected to have VAP without ARDS. However, in this patient population, discrimination of these breath biomarkers for ARDS was poor, indicating the difficulty of translating diagnostic tests between clinical settings.