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Breath analysis for detection and trajectory monitoring of acute respiratory distress syndrome in swine

Ruchi Sharma, Menglian Zhou, Mohamad Hakam Tiba, Brendan M. McCracken, Robert P. Dickson, Christopher E. Gillies, Michael W. Sjoding, Jean A. Nemzek, Kevin R. Ward, Kathleen A. Stringer, Xudong Fan
ERJ Open Research 2021; DOI: 10.1183/23120541.00154-2021
Ruchi Sharma
1Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, U.S.A
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Menglian Zhou
1Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, U.S.A
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  • ORCID record for Menglian Zhou
Mohamad Hakam Tiba
2Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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Brendan M. McCracken
2Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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Robert P. Dickson
4Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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  • ORCID record for Robert P. Dickson
Christopher E. Gillies
2Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
5Michigan Institute for Data Science (MIDAS), Office of Research, University of Michigan, Ann Arbor, MI, U.S.A
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Michael W. Sjoding
4Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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Jean A. Nemzek
6Unit of Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI, U.S.A
7Department of Pathology, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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Kevin R. Ward
1Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, U.S.A
2Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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Kathleen A. Stringer
4Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
8Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, U.S.A
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Xudong Fan
1Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, U.S.A
3Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, U.S.A
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  • For correspondence: xsfan@umich.edu
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Abstract

Despite the enormous impact on human health, acute respiratory distress syndrome (ARDS) is ill-defined, and its timely diagnosis is difficult, as is tracking the course of the syndrome. The objective of this pilot study was to explore the utility of breath collection and analysis methodologies to detect ARDS through changes in the volatile organic compound (VOC) profiles present in breath. Five male Yorkshire mix swine were studied and ARDS was induced utilising both direct and indirect lung injury. An automated portable gas chromatography device developed in-house was used for point of care breath analysis and to monitor swine breath hourly, starting from the initiation of the experiment until the development of ARDS, which was adjudicated based on the Berlin criteria at the breath sampling points and confirmed by lung biopsy at the end of the experiment. A total of 67 breath samples (chromatograms) were collected and analyzed. Through machine learning, principal component analysis, and linear discrimination analysis, seven VOCs biomarkers were identified that distinguished ARDS. These represent seven of the nine biomarkers found in our breath analysis study of human ARDS corroborating our findings. We also demonstrated that breath analysis detects changes 1–6 h earlier than the clinical adjudication based on the Berlin criteria. The findings provide proof of concept that breath analysis can be used for the identification of early changes associated with ARDS pathogenesis in swine. Its clinical application could provide intensive care clinicians with a non-invasive diagnostic tool for early detection and continuous monitoring of ARDS.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Ruchi Sharma

Conflict of interest: Menglian Zhou

Conflict of interest: Mohamad Hakam Tiba

Conflict of interest: Brendan M. McCracken

Conflict of interest: Robert P. Dickson

Conflict of interest: Christopher E. Gillies

Conflict of interest: Michael W. Sjoding

Conflict of interest: Dr. Nemzek has nothing to disclose.

Conflict of interest: Kevin R. Ward

Conflict of interest: Kathleen A. Stringer

Conflict of interest: Xudong Fan

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received March 7, 2021.
  • Accepted September 19, 2021.
  • Copyright ©The authors 2021
http://creativecommons.org/licenses/by-nc/4.0/

This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org

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Breath analysis for detection and trajectory monitoring of acute respiratory distress syndrome in swine
Ruchi Sharma, Menglian Zhou, Mohamad Hakam Tiba, Brendan M. McCracken, Robert P. Dickson, Christopher E. Gillies, Michael W. Sjoding, Jean A. Nemzek, Kevin R. Ward, Kathleen A. Stringer, Xudong Fan
ERJ Open Research Jan 2021, 00154-2021; DOI: 10.1183/23120541.00154-2021

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Breath analysis for detection and trajectory monitoring of acute respiratory distress syndrome in swine
Ruchi Sharma, Menglian Zhou, Mohamad Hakam Tiba, Brendan M. McCracken, Robert P. Dickson, Christopher E. Gillies, Michael W. Sjoding, Jean A. Nemzek, Kevin R. Ward, Kathleen A. Stringer, Xudong Fan
ERJ Open Research Jan 2021, 00154-2021; DOI: 10.1183/23120541.00154-2021
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