Exhaled breath acetone in predicting the presence and severity of respiratory failure.

IF 3.7 4区 医学 Q1 BIOCHEMICAL RESEARCH METHODS
Yating Wang, Chunwei He, Ziyu Fu, Hui Wang, Dedong Ma
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Abstract

Respiratory failure (RF) has a high mortality rate and poor prognosis, making the development of novel non-invasive biomarkers crucial. Hypoxia promotes lipolysis, increasing free fatty acid (FFA) and ketones. Exhaled breath acetone (EBA), a volatile component of ketone bodies, may be linked to the presence and severity of RF. In this study, 156 patients were enrolled and categorized based on arterial blood gas analysis into RF group (N= 74) and control group (N= 82). The EBA was compared between the two groups. RF patients were classified by PaO2/FiO2(P/F): high P/F (200 ⩽ P/F < 300 mmHg;N= 42) and low P/F (P/F < 200 mmHg;N= 32), and subsequently EBA was compared. Multivariate and multiple-model logistic regression analyses were employed to investigate the impacts of EBA on the RF. Additionally, receiver operator characteristic curve was utilized to evaluate the diagnostic efficacy of EBA. The RF group presented a significantly higher EBA [1.61 (0.98-2.57) vs 1.24 (0.86-1.69) ppm,P= 0.001], compared to the control group. The EBA within the low P/F group was higher than within the high P/F group [2.43 (1.57-3.23) vs 1.37 (0.91-1.83) ppm,P< 0.001]. EBA was conspicuously negatively correlated with PaO2/FiO2, and positively correlated with beta-hydroxybutyrate and FFA. Logistic regression analyses demonstrated that EBA was correlated with the presence and severity of RF. The area under curve of EBA in the diagnosis of RF and low P/F were 0.651 (95% CI: 0.564-0.738,P= 0.001) and 0.763 (95% CI: 0.652-0.875,P< 0.001). EBA can serve as a valuable predictor for the presence and severity of RF.

呼气丙酮预测呼吸衰竭的存在和严重程度。
呼吸衰竭(RF)死亡率高,预后差,因此开发新的无创生物标志物至关重要。缺氧促进脂肪分解,增加游离脂肪酸(FFA)和酮。呼出的丙酮(EBA)是酮体的挥发性成分,可能与射频的存在和严重程度有关。本研究纳入156例患者,根据动脉血气分析分为RF组(N= 74)和对照组(N= 82)。比较两组患者的EBA。将RF患者按PaO2/FiO2(P/F)分为高P/F(200±P/F < 300 mmHg, N= 42)和低P/F (P/F < 200 mmHg, N= 32),并进行EBA比较。采用多变量和多模型logistic回归分析探讨EBA对射频的影响。此外,采用受试者操作者特征曲线评价EBA的诊断效果。与对照组相比,RF组的EBA显著升高[1.61(0.98-2.57)对1.24 (0.86-1.69)ppm,P= 0.001]。低P/F组的EBA高于高P/F组[2.43(1.57-3.23)比1.37 (0.91-1.83)ppm,P< 0.001]。EBA与PaO2/FiO2呈显著负相关,与β -羟基丁酸和FFA呈正相关。Logistic回归分析显示EBA与RF的存在和严重程度相关。EBA诊断RF和低P/F的曲线下面积分别为0.651 (95% CI: 0.564 ~ 0.738,P= 0.001)和0.763 (95% CI: 0.652 ~ 0.875,P< 0.001)。EBA可以作为RF存在和严重程度的有价值的预测因子。
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来源期刊
Journal of breath research
Journal of breath research BIOCHEMICAL RESEARCH METHODS-RESPIRATORY SYSTEM
CiteScore
7.60
自引率
21.10%
发文量
49
审稿时长
>12 weeks
期刊介绍: Journal of Breath Research is dedicated to all aspects of scientific breath research. The traditional focus is on analysis of volatile compounds and aerosols in exhaled breath for the investigation of exogenous exposures, metabolism, toxicology, health status and the diagnosis of disease and breath odours. The journal also welcomes other breath-related topics. Typical areas of interest include: Big laboratory instrumentation: describing new state-of-the-art analytical instrumentation capable of performing high-resolution discovery and targeted breath research; exploiting complex technologies drawn from other areas of biochemistry and genetics for breath research. Engineering solutions: developing new breath sampling technologies for condensate and aerosols, for chemical and optical sensors, for extraction and sample preparation methods, for automation and standardization, and for multiplex analyses to preserve the breath matrix and facilitating analytical throughput. Measure exhaled constituents (e.g. CO2, acetone, isoprene) as markers of human presence or mitigate such contaminants in enclosed environments. Human and animal in vivo studies: decoding the ''breath exposome'', implementing exposure and intervention studies, performing cross-sectional and case-control research, assaying immune and inflammatory response, and testing mammalian host response to infections and exogenous exposures to develop information directly applicable to systems biology. Studying inhalation toxicology; inhaled breath as a source of internal dose; resultant blood, breath and urinary biomarkers linked to inhalation pathway. Cellular and molecular level in vitro studies. Clinical, pharmacological and forensic applications. Mathematical, statistical and graphical data interpretation.
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