Chest
Clinical Investigations in Critical CareExhaled Breath Condensate Nitrite and Its Relation to Tidal Volume in Acute Lung Injury
Section snippets
Patients
Inclusion criteria for this study were defined by acute respiratory failure due to pneumonia or COPD exacerbation leading to a minimum of 24 h of mechanical ventilation. After that time, patients had to be hemodynamically (no change in IV catecholamines of > 25% of baseline) and respiratory stable (no alteration in ventilator settings). A time frame of an additional 48 h was allowed to reach these criteria and to collect EBC without interference by necessary ICU procedures. Ventilator settings
EBC NO2− and Clinical Scores
EBC NO2− was significantly different in the three patient groups: EBC NO2− was increased in patients with ARDS compared to patients with ALI criteria or patients without signs of lung injury according to both AECC (ARDS, 6.28 ± 1.94 μmol/L; ALI, 4.56 ± 1.32 μmol/L; no lung injury, 3.58 ± 1.52 μmol/L) as well as LISS criteria (ARDS, 6.26 ± 1.71 μmol/L; ALI, 4.61 ± 1.70 μmol/L; no lung injury, 3.23 ± 2.07 μmol/L) [Fig 1].
EBC NO2− and Ventilatory Parameters
Table 2summarizes the correlations between EBC NO2− and ventilatory
Discussion
Nitrite, generated by nitric oxide in aqueous media, has often been regarded to be a marker of inflammation.11,26 It may therefore not have come to anyone's surprise that NO2− was observed in EBC of ventilated patients with lung injury due to pneumonia or exacerbation of COPD. At first sight, a relation of inflammation and EBC NO2− is further suggested by a (weak) correlation of lung injury scores and EBC NO2−. However, further analysis of factors influencing EBC NO2− has led us to suggest a
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Cited by (59)
Exhaled breath condensate pH in mechanically ventilated patients
2013, Medicina IntensivaCitation Excerpt :Other studies in MV patients have detected significant correlations between the EBC NO2/Vt ratio and the Lung Injury Score and PaO2/FIO2 ratio, suggesting that increases in the EBC NO2/Vt ratio may be explained by greater mechanical alveolar stress.13 Nitrite from EBC has also been reported to correlate with both the tidal volume (adapted to ideal body weight) and to the extent of lung injury, and thus it may be indicative of mechanical stress in ventilated lungs.14 Even when we could not refuse the alveolar mechanical stress as source of acidity, hypoventilation strategy was a common practice in the ICU (mean tidal volume 7.98 ml/kg [predicted body weight] and respiratory rate of 14/min; Table 1) and the mean PEEP was also low (3.47 cm H2O; Table 1).
Capillary electrophoresis - A new tool for ionic analysis of exhaled breath condensate
2012, Journal of Chromatography AExhaled breath condensate collection in the mechanically ventilated patient
2012, Respiratory MedicineNitric Oxide in the Exhaled Breath Condensate of Healthy Volunteers Collected With a Reusable Device
2012, Archivos de BronconeumologiaCitation Excerpt :Exhaled NO has been intensely researched and seems to be a useful marker in asthma9 and chronic obstructive pulmonary disease (COPD).10 Its values have also been demonstrated to be higher in lung cancer patients11 and can be correlated with clinical lung injury scores.12 Despite the fact that devices for collecting EBC are commercially available, these devices are disposable and in many countries they are not readily available, especially in developing countries where the import costs limit their systematic use in clinical practice.
Mechanical ventilation induces changes in exhaled breath condensate of patients without lung injury
2010, Respiratory MedicineCitation Excerpt :The same fact could explain the correlations observed with dynamic compliance and RR. In this sense, previous studies in MV patients have detected significant correlations between the EBC NO2/Vt ratio and the Lung Injury Score and PaO2/FIO2 ratio,16 suggesting that increases in the EBC NO2/Vt ratio may be explained by greater mechanical stress. In the present study, however, this correlation was not found, possibly because of the small sample size and the fact that only patients without ALI were included.
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