Exhaled breath analysis to diagnose acute lung injury.

The acute respiratory distress syndrome (ARDS) is a severe complication of critical illness characterized by acute onset, protein rich, pulmonary edema and is associated with mortality rates above 40%. Early diagnosis and monitoring are major challenges. The diagnosis is based on timing, chest-radiography, origin of edema and the oxygenation values. However, still in half of the cases the diagnosis was missed. (ref) Gas-chromatography mass-spectrometry (GC-MS) is used in exhaled breath analysis to obtain concentrations of volatile compounds (VOCs). A biomarker that was found to be associated with ARDS is octane. Since GC-MS is labour intensive, requires specialized personnel and is not available bedside, it is not suitable for use in the intensive care unit (ICU) setting. Therefore a smaller device was developed which can quantitatively measure octane in exhaled breath. This point of care prototype will be tested in clinical setting and will be compared with other non-invasive diagnostic tests. Goal of this study is (1) to evaluate the diagnostic accuracy of a point of care octane breath test for ARDS in intubated and mechanically ventilated ICU patients; (2) to evaluate the association between changes in exhaled octane concentrations and changes in the clinical characteristics of patients with ARDS; and (3) to compare the diagnostic and predictive (additive) accuracy of several non-invasive tests for ARDS.

Octane concentrations in exhaled breath facilitate early detection of ARDS in ICU patients.

Within 48 hours after intubation untill a follow up of 90 days.
First measurement within 48 hours after intubation, second 24 hours later.

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