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Title:Analysis of exhaled breath to identify critically ill patients with ventilator-associated pneumonia
Authors:ID Felton, T. W. (Author)
ID Ahmed, Waqar (Author)
ID White, Iain R. (Author)
ID Oort, Pouline M. van (Author)
ID Rattray, Nicholas J. W. (Author)
ID Docherty, C. (Author)
ID Bannard-Smith, Jonathan (Author)
ID Morton, J.B. (Author)
ID Welters, Ingeborg (Author)
ID McMullan, R. (Author), et al.
Files:.pdf Anaesthesia_-_2023_-_Felton_-_Analysis_of_exhaled_breath_to_identify_critically_ill_patients_with_ventilator‐associated.pdf (237,72 KB)
MD5: 48926E00BE73AD78CFD386E333F191A2
Work type:Unknown
Typology:1.01 - Original Scientific Article
Organization:UNG - University of Nova Gorica
Abstract:Ventilator-associated pneumonia commonly occurs in critically ill patients. Clinical suspicion results in overuse of antibiotics, which in turn promotes antimicrobial resistance. Detection of volatile organic compounds in the exhaled breath of critically ill patients might allow earlier detection of pneumonia and avoid unnecessary antibiotic prescription. We report a proof of concept study for non-invasive diagnosis of ventilator-associated pneumonia in intensive care (the BRAVo study). Mechanically ventilated critically ill patients commenced on antibiotics for clinical suspicion of ventilator-associated pneumonia were recruited within the first 24 h of treatment. Paired exhaled breath and respiratory tract samples were collected. Exhaled breath was captured on sorbent tubes and then analysed using thermal desorption gas chromatography–mass spectrometry to detect volatile organic compounds. Microbiological culture of a pathogenic bacteria in respiratory tract samples provided confirmation of ventilator-associated pneumonia. Univariable and multivariable analyses of volatile organic compounds were performed to identify potential biomarkers for a ‘rule-out’ test. Ninety-six participants were enrolled in the trial, with exhaled breath available from 92. Of all compounds tested, the four highest performing candidate biomarkers were benzene, cyclohexanone, pentanol and undecanal with area under the receiver operating characteristic curve ranging from 0.67 to 0.77 and negative predictive values from 85% to 88%. Identified volatile organic compounds in the exhaled breath of mechanically ventilated critically ill patients show promise as a useful non-invasive ‘rule-out’ test for ventilator-associated pneumonia.
Keywords:breath, diagnosis, ventilator-associated pneumonia
Publication date:01.01.2023
Year of publishing:2023
Number of pages:Str. 712-721
Numbering:Vol. 78, iss. 6
PID:20.500.12556/RUNG-8103-62c8f7d0-8015-1827-f8c3-8dfaf5f3ef2f New window
COBISS.SI-ID:147847939 New window
ISSN on article:1365-2044
DOI:10.1111/anae.15999 New window
Publication date in RUNG:05.04.2023
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Publisher:Blackwell Science
COBISS.SI-ID:515009817 New window


License:CC BY 4.0, Creative Commons Attribution 4.0 International
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:04.04.2023