| Title: | Volatile Organic Compounds in Patients With Acute Kidney Injury and Changes During Dialysis |
| Author(s): | Huppe T; Klasen R; Maurer F; Meiser A; Groesdonk HV; Sessler DI; Fink T; Kreuer S; |
| Address: | "Department of Anesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg (Saar), Germany. Department of Anesthesiology and Intensive Care, Klinikum Lunen St.-Marien-Hospital, Lunen, Germany. Department of Outcomes Research, Anesthesiology Institute" |
| DOI: | 10.1097/CCM.0000000000003523 |
| ISSN/ISBN: | 1530-0293 (Electronic) 0090-3493 (Linking) |
| Abstract: | "OBJECTIVES: To characterize volatile organic compounds in breath exhaled by ventilated care patients with acute kidney injury and changes over time during dialysis. DESIGN: Prospective observational feasibility study. SETTING: Critically ill patients on an ICU in a University Hospital, Germany. PATIENTS: Twenty sedated, intubated, and mechanically ventilated patients with acute kidney injury and indication for dialysis. INTERVENTIONS: Patients exhalome was evaluated from at least 30 minutes before to 7 hours after beginning of continuous venovenous hemodialysis. MEASUREMENTS AND MAIN RESULTS: Expired air samples were aspirated from the breathing circuit at 20-minute intervals and analyzed using multicapillary column ion-mobility spectrometry. Volatile organic compound intensities were compared with a ventilated control group with normal renal function. A total of 60 different signals were detected by multicapillary column ion-mobility spectrometry, of which 44 could be identified. Thirty-four volatiles decreased during hemodialysis, whereas 26 remained unaffected. Forty-five signals showed significant higher intensities in patients with acute kidney injury compared with control patients with normal renal function. Among these, 30 decreased significantly during hemodialysis. Volatile cyclohexanol (23 mV; 2575th, 19-38), 3-hydroxy-2-butanone (16 mV, 9-26), 3-methylbutanal (20 mV; 14-26), and dimer of isoprene (26 mV; 18-32) showed significant higher intensities in acute kidney impairment compared with control group (12 mV; 10-16 and 8 mV; 7-14 and not detectable and 4 mV; 0-6; p < 0.05) and a significant decline after 7 hours of continuous venovenous hemodialysis (16 mV; 13-21 and 7 mV; 6-13 and 9 mV; 8-13 and 14 mV; 10-19). CONCLUSIONS: Exhaled concentrations of 45 volatile organic compounds were greater in critically ill patients with acute kidney injury than in patients with normal renal function. Concentrations of two-thirds progressively decreased during dialysis. Exhalome analysis may help quantify the severity of acute kidney injury and to gauge the efficacy of dialysis" |
| Keywords: | "Acute Kidney Injury/*metabolism/therapy Aged Breath Tests Exhalation Feasibility Studies Female Humans Male Prospective Studies Renal Dialysis Respiration, Artificial Volatile Organic Compounds/analysis/*metabolism;" |
| Notes: | "MedlineHuppe, Tobias Klasen, Robert Maurer, Felix Meiser, Andreas Groesdonk, Heinrich-Volker Sessler, Daniel I Fink, Tobias Kreuer, Sascha eng Observational Study 2018/10/27 Crit Care Med. 2019 Feb; 47(2):239-246. doi: 10.1097/CCM.0000000000003523" |
