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. 2020 Nov 12;15(1):016011.
doi: 10.1088/1752-7163/abc235.

Exhaled breath condensate biomarkers in critically ill, mechanically ventilated patients

Michael D Davis  1 , Brett R Winters  2 , Michael C Madden  3 , Joachim D Pleil  4 , Curtis N Sessler  5 , M Ariel Geer Wallace  6 , Cavin K Ward-Caviness  3 , Alison J Montpetit  7
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Exhaled breath condensate biomarkers in critically ill, mechanically ventilated patients

Michael D Davis et al. J Breath Res. .

Abstract

Pneumonia is a significant risk for critically ill, mechanically ventilated (CIMV) patients. Diagnosis of pneumonia generally requires a combination of clinician-guided diagnoses and clinical scoring systems. Exhaled breath condensate (EBC) can be safely collected non-invasively from CIMV patients. Hundreds of biomarkers in EBC are associated with acute disease states, including pneumonia. We evaluated cytokines in EBC from CIMV patients and hypothesized that these biomarkers would correlate with disease severity in pneumonia, sepsis, and death. EBC IL-2 levels were associated with chest radiograph severity scores (odds ratio = 1.68; 95% confidence interval = 1.09-2.60; P = 0.02). EBC TNF-α levels were also associated with pneumonia (odds ratio = 3.20; 95% confidence interval = 1.19-8.65; P = 0.02). The techniques and results from this study may be useful for all mechanically ventilated patients.

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Figures

Figure 1:
Figure 1:
Association between cytokines assessed in EBC and the clinical outcomes of CPIS and CXRAY using a generalized estimating equations model. An odds ratio greater than 1 is indicative of a positive association between the cytokine and the outcome; an odds ratio equal to 1 indicates that the cytokine and the outcome are independent of one another; an odds ratio of less than 1 is indicative of an inverse association between the cytokine and the outcome. CPIS = clinical pulmonary infection score; CXRAY = chest radiograph score.
Figure 2:
Figure 2:
Associations between cytokines assessed in EBC and the outcomes of Death, Pneumonia, and Sepsis. An odds ratio greater than 1 is indicative of a positive association between the cytokine and the outcome; an odds ratio equal to 1 indicates that the cytokine and the outcome are independent of one another; an odds ratio of less than 1 is indicative of an inverse association between the cytokine and the outcome.
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