An adaptive breath sampler for use with human subjects with an impaired respiratory function

An adaptive sampler for collecting 2.5 dm(3) samples of exhaled air from human subjects with an impaired respiratory function is described. Pressure in the upper respiratory tract is continuously monitored and the data used to control an automated system to collect select portions of the expired breathing cycle onto a mixed bed Tenax(trade mark) and Carbotrap(trade mark) adsorbent trap for analysis by GC-MS. The sampling approach is intended for use in metabolomic profiling of volatiles in human breath at concentrations greater than microg m(-3). The importance of experimental reproducibility in metabolomic data is emphasised and consequently a high purity air supply is used to maintain a stable exogenous volatile organic compound profile at concentrations in the range 5 to 30 microg m(-3). The results of a 90 day stability study showed that exogenous VOCs were maintained at significantly lower levels (40 times lower for isopropyl alcohol) and with significantly higher reproducibility (80 times lower standard deviation for isopropyl alcohol) than would have been be the case if ambient air had been used. The sampling system was evaluated with healthy controls alongside subjects with chronic obstructive pulmonary disease. Subjects were able to breathe normally with control subjects observed to breathe at a rate of 9 to 17 breaths per minute, compared to 16 to 30 breaths per minute for subjects with COPD. This study presents, for the first time, observations and estimates of intra-subject breath sample reproducibility from human subjects. These reproducibility studies indicated that VOCs in exhaled breath exhibit a variety of dynamic behaviours, with some species recovered with a RSD <30%, while other species were observed to have significantly more variable concentrations, 30 to 130% RSD. The approach was also demonstrated to reliably differentiate the differences in the VOC profiles between alveolar and dead space air.     

柔性PDA薄膜阵列用于双模光学检测VOC标志物气体

本研究以亲油性的双面胶作为基底,利用滴涂二乙炔单体结合紫外光聚合来制备均匀的聚二乙炔(PDA)薄膜,通过荧光和颜色两种信号变化模式(即"双模光学检测")研究了PDA薄膜对VOC气体的响应性,发现制备的PDA薄膜在2 min内就可以实现明显的荧光和颜色变化,有效解决了目前PDA薄膜在VOC气体检测方面存在响应速度慢、薄膜均一性差等问题.此外,为解决单一PDA薄膜的交叉响应性问题,本研究制备了四种不同的基于双面胶基底的PDA薄膜,并将制备的4种PDA薄膜集成到一片PDMS薄膜基底上来构建柔性的传感阵列,利用阵列的颜色变化结合模式识别技术,实现了对8种VOC气体的快速、灵敏区分.进一步将制备的PDA薄膜阵列用于健康人、模拟糖尿病及肾病患者呼出气体中VOC标志物的辨别和分析研究,发现可以将三类人的呼出气体清晰地区分,说明了该阵列在呼气疾病诊断中的应用前景.与目前报道的PDA薄膜阵列相比,本研究中基于双面胶基底的PDA薄膜阵列具有气体响应速度快、灵敏性高、柔韧性好、制备工艺简单、成本低、易于大规模制备等优点,有望用于实VOC气体检测研究中.     

Human breath analysis: methods for sample collection and reduction of localized background effects

Solid-phase microextraction (SPME) was applied, in conjunction with gas chromatography–mass spectrometry, to the analysis of volatile organic compounds (VOCs) in human breath samples without requiring exhaled breath condensate collection. A new procedure, exhaled breath vapor (EBV) collection, involving the active sampling and preconcentration of a breath sample with a SPME fiber fitted inside a modified commercial breath-collection device, the RTube™, is described. Immediately after sample collection, compounds are desorbed from the SPME fiber at 250 °C in the GC-MS injector. Experiments were performed using EBV collected at −80 °C and at room temperature, and the results compared to the traditional method of collecting exhaled breath condensate at −80 °C followed by passive SPME sampling of the collected condensate. Methods are compared in terms of portability, ease-of-use, speed of analysis, and detection limits. The need for a clean air supply for the study subjects is demonstrated using several localized sources of VOC contaminants including nail polish, lemonade, and gasoline. Various simple methods to supply clean inhaled air to a subject are presented. Chemical exposures are used to demonstrate the importance of providing cleaned air (organic vapor respirator) or an external air source (tubing stretched to a separate room). These techniques allow for facile data interpretation by minimizing background contaminants. It is demonstrated herein that this active SPME breath-sampling device provides advantages in the forms of faster sample collection and data analysis, apparatus portability and avoidance of power or cooling requirements, and performance for sample collection in a contaminated environment.      

Pilot Study on Exhaled Breath Analysis for a Healthy Adult Population in Hawaii

Fast diagnostic results using breath analysis are an anticipated possibility for disease diagnosis or general health screenings. Tests that do not require sending specimens to medical laboratories possess capabilities to speed patient diagnosis and protect both patient and healthcare staff from unnecessary prolonged exposure. The objective of this work was to develop testing procedures on an initial healthy subject cohort in Hawaii to act as a range-finding pilot study for characterizing the baseline of exhaled breath prior to further research. Using comprehensive two-dimensional gas chromatography (GC×GC), this study analyzed exhaled breath from a healthy adult population in Hawaii to profile the range of different volatile organic compounds (VOCs) and survey Hawaii-specific differences. The most consistently reported compounds in the breath profile of individuals were acetic acid, dimethoxymethane, benzoic acid methyl ester, and n-hexane. In comparison to other breathprinting studies, the list of compounds discovered was representative of control cohorts. This must be considered when implementing proposed breath diagnostics in new locations with increased interpersonal variation due to diversity. Further studies on larger numbers of subjects over longer periods of time will provide additional foundational data on baseline breath VOC profiles of control populations for comparison to disease-positive cohorts.     

Comprehensive Two-Dimensional Gas Chromatography–Mass Spectrometry Analysis of Exhaled Breath Compounds after Whole Grain Diets

Exhaled breath is a potential noninvasive matrix to give new information about metabolic effects of diets. In this pilot study, non-targeted analysis of exhaled breath volatile organic compounds (VOCs) was made by comprehensive two-dimensional gas chromatography–mass spectrometry (GCxGC-MS) to explore compounds relating to whole grain (WG) diets. Nine healthy subjects participated in the dietary intervention with parallel crossover design, consisting of two high-fiber diets containing whole grain rye bread (WGR) or whole grain wheat bread (WGW) and 1-week control diets with refined wheat bread (WW) before both diet periods. Large interindividual differences were detected in the VOC composition. About 260 VOCs were detected from exhaled breath samples, in which 40 of the compounds were present in more than half of the samples. Various derivatives of benzoic acid and phenolic compounds, as well as some furanones existed in exhaled breath samples only after the WG diets, making them interesting compounds to study further.     

Volatile Organic Compound Based Probe for Induced Volatolomics of Cancers

The development of efficient protocols for cancer diagnosis remains highly challenging. An emerging approach relies on the detection in exhaled breath of volatile organic compounds (VOC) produced by tumours. In this context, described here is a novel strategy in which a VOC‐based probe is converted selectively in malignant tissues, by a tumour‐associated enzyme, for releasing the corresponding VOC. The latter is then detected in the exhaled breath as a tumour marker for cancer diagnosis. This approach allows the detection of several different tumours in mice, the monitoring of tumour growth and tumour response to chemotherapy. Thus, the concept of “induced volatolomics” provides a new way to explore biological processes using VOC‐based probes that could be adapted to many biomedical applications.     

Phase-resolved real-time breath analysis during exercise by means of smart processing of PTR-MS data

Separation of inspiratory, mixed expired and alveolar air is indispensable for reliable analysis of VOC breath biomarkers. Time resolution of direct mass spectrometers often is not sufficient to reliably resolve the phases of a breathing cycle. To realise fast on-line breath monitoring by means of direct MS utilising low-fragmentation soft ionisation, a data processing algorithm was developed to identify inspiratory and alveolar phases from MS data without any additional equipment. To test the algorithm selected breath biomarkers (acetone, isoprene, acetaldehyde and hexanal) were determined by means of quadrupole proton transfer reaction mass spectrometry (PTR-MS) in seven healthy volunteers during exercise on a stationary bicycle. The results were compared to an off-line reference method consisting of controlled alveolar breath sampling in Tedlar® bags, preconcentration by solid-phase micro extraction (SPME), separation and identification by GC-MS. Based on the data processing method, quantitative attribution of biomarkers to inspiratory, alveolar and mixed expiratory phases was possible at any time during the experiment, even under respiratory rates up to 60/min. Alveolar concentrations of the breath markers, measured by PTR-MS ranged from 130 to 2,600 ppb (acetone), 10 to 540 ppb (isoprene), 2 to 31 ppb (acetaldehyde), whereas the concentrations of hexanal were always below the limit of detection (LOD) of 3 ppb. There was good correlation between on-line PTR-MS and SPME-GC-MS measurements during phases with stable physiological parameters but results diverged during rapid changes of heart rate and minute ventilation. This clearly demonstrates the benefits of breath-resolved MS for fast on-line monitoring of exhaled VOCs.

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Figure Experimental setup showing bicycle ergometer and analytical pathways: Right side PTR-MS: identification of respiratory phases by means of the new algorithm. Left side: confirmation of PTR-MS data for exhaled isoprene by means of GC-MS analysis

     

One-year time series of investigations of analytes within human breath using ion mobility spectrometry

Ion mobility Spectrometry is used to detect volatile analytes within human breath directly. Many volatile organic compounds (VOC) show significant day-to-day variation in the signal height related to the concentration of the analyte, although the breath collection had been performed under the same conditions with respect to similar sampling procedure, similar dead volume, similar measurement time, and measurement conditions. Variations of 8 different analytes are investigated over a time period of 11 months in the exhaled breath of the same person in the same room environment. The individual variability is reported for Benzothiazole; D-Limonene; Eucalyptol; Decamethylcyclopentasiloxane; Decanal; 1-Hexanol, 2-ethyl-; Cyclohexanone, 5-methyl-2-(1-methylethyl) and Nonanal. The paper shows, that the individual variability must be taken into consideration to relate the findings to medical questions. Therefore, the room air concentration of VOCs must be taken into account, so that the difference between exhaled and inhaled air has to be used as indicator. Finally, starting with individual variabilities, the normal variation related to the specific analyte should be considered in addition.     

New method for determination of trihalomethanes in exhaled breath: Applications to swimming pool and bath environments

A method for the estimation of the human intake of trihalomethanes (THMs), namely chloroform, bromodichloromethane, dibromochloromethane and bromoform, during showering and bathing is reported. The method is based on the determination of these compounds in exhaled breath that is collected by solid adsorption on Tenax using a device specifically designed for this purpose. Instrumental measurements were performed by automatic thermal desorption coupled to gas chromatography with electron capture detection. THMs in exhaled breath samples were determined during showering and swimming pool attendance. The levels of these compounds in indoor air and water were also determined as reference for interpretation of the exhaled breath results. The THM concentrations in exhaled breath of the volunteers measured before the exposure experiments showed a close correspondence with the THMs levels in indoor air where the sampler was located. Limits of detection in exhaled breath were dependent on THM analytes and experimental sites. They ranged between 170 and 710 ng m⁻³ in the swimming pool studies and between 97 and 460 ng m⁻³ in the showering studies. Application of this method to THMs determination during showering and swimming pool activities revealed statistically significant increases in THMs concentrations when comparing exhaled breath before and after exposure.     

The Influence of Smoking Status on Exhaled Breath Profiles in Asthma and COPD Patients

Breath analysis using eNose technology can be used to discriminate between asthma and COPD patients, but it remains unclear whether results are influenced by smoking status. We aim to study whether eNose can discriminate between ever- vs. never-smokers and smoking <24 vs. >24 h before the exhaled breath, and if smoking can be considered a confounder that influences eNose results. We performed a cross-sectional analysis in adults with asthma or chronic obstructive pulmonary disease (COPD), and healthy controls. Ever-smokers were defined as patients with current or past smoking habits. eNose measurements were performed by using the SpiroNose. The principal component (PC) described the eNose signals, and linear discriminant analysis determined if PCs classified ever-smokers vs. never-smokers and smoking <24 vs. >24 h. The area under the receiver–operator characteristic curve (AUC) assessed the accuracy of the models. We selected 593 ever-smokers (167 smoked <24 h before measurement) and 303 never-smokers and measured the exhaled breath profiles of discriminated ever- and never-smokers (AUC: 0.74; 95% CI: 0.66–0.81), and no cigarette consumption <24h (AUC 0.54, 95% CI: 0.43–0.65). In healthy controls, the eNose did not discriminate between ever or never-smokers (AUC 0.54; 95% CI: 0.49–0.60) and recent cigarette consumption (AUC 0.60; 95% CI: 0.50–0.69). The eNose could distinguish between ever and never-smokers in asthma and COPD patients, but not recent smokers. Recent smoking is not a confounding factor of eNose breath profiles.     

Ultrafast gas chromatography coupled to electronic nose to identify volatile biomarkers in exhaled breath from chronic obstructive pulmonary disease patients: A pilot study

An analytical method to identify volatile organic compounds (VOCs) in the exhaled breath from patients with a diagnosis of chronic obstructive pulmonary disease (COPD) using a ultrafast gas chromatography system equipped with an electronic nose detector (FGC eNose) has been developed. A prospective study was performed in 23 COPD patients and 33 healthy volunteers; exhalation breathing tests were performed with Tedlar bags. Each sample was analyzed by FCG eNose and the identification of VOCs was based on the Kovats index. Raw data were reduced by principal component analysis (PCA) and canonical discriminant analysis [canonical analysis of principal coordinates (CAP)]. The FCG eNose technology was able to identify 17 VOCs that distinguish COPD patients from healthy volunteers. At all stages of PCA and CAP the discrimination between groups was obvious. Chemical prints were correctly classified up to 82.2%, and were matched with 78.9% of the VOCs detected in the exhaled breath samples. Receiver operating characteristic curve analysis indicated the sensitivity and specificity to be 96% and 91%, respectively. This pilot study demonstrates that FGC eNose is a useful tool to identify VOCs as biomarkers in exhaled breath from COPD patients. Further studies should be performed to enhance the clinical relevance of this quick and ease methodology for COPD diagnosis.     

Detection of Paratuberculosis in Dairy Herds by Analyzing the Scent of Feces,Alveolar Gas,and Stable Air

Paratuberculosis is an important disease of ruminants caused by Mycobacterium avium ssp. paratuberculosis (MAP). Early detection is crucial for successful infection control, but available diagnostic tests are still dissatisfying. Methods allowing a rapid, economic, and reliable identification of animals or herds affected by MAP are urgently required. This explorative study evaluated the potential of volatile organic compounds (VOCs) to discriminate between cattle with and without MAP infections. Headspaces above fecal samples and alveolar fractions of exhaled breath of 77 cows from eight farms with defined MAP status were analyzed in addition to stable air samples. VOCs were identified by GC–MS and quantified against reference substances. To discriminate MAP-positive from MAP-negative samples, VOC feature selection and random forest classification were performed. Classification models, generated for each biological specimen, were evaluated using repeated cross-validation. The robustness of the results was tested by predicting samples of two different sampling days. For MAP classification, the different biological matrices emitted diagnostically relevant VOCs of a unique but partly overlapping pattern (fecal headspace: 19, alveolar gas: 11, stable air: 4–5). Chemically, relevant compounds belonged to hydrocarbons, ketones, alcohols, furans, and aldehydes. Comparing the different biological specimens, VOC analysis in fecal headspace proved to be most reproducible, discriminatory, and highly predictive.     

On-line, real time monitoring of exhaled trace gases by SIFT-MS in the perioperative setting: a feasibility study

A study is described of the first on line, real time analyses of the exhaled breath of five anaesthetized patients during the complete perioperative periods of laparoscopic surgery. These breath analyses were achieved using a selected ion flow tube, SIFT-MS, instrument, located in the operating theatre at an acceptable distance from the operating table, and coupled to the endotracheal tube in the ventilation circuit via a 5 metre long capillary tube. Thus, inhalation/exhalation breathing cycles, set to be at a frequency of 10 per minute, were sampled continuously for water vapour, the metabolites acetone and isoprene and the propofol used to induce anaesthesia for each operating period that ranged from 20 min (shortest) to 80 min (longest). Whilst there was some loss of water vapour along the long sampling line, the concentrations of the other trace compounds were not diminished. The breath acetone was essentially at a constant level for each patient, but increased somewhat over the longest operating period due to the onset of lipolysis. Most interesting is the clear increase of breath isoprene following abdomen inflation with carbon dioxide. The vapour of the intravenously injected propofol was detected in the exhaled breath and remained essentially constant during the perioperative period. These analyses were performed totally non-invasively and the data were immediately and constantly available to the anaesthetist and surgeon. Exploitation of this development could influence decision making and potentially improve patient safety within the perioperative setting.     

Non-invasive spatial visualization system of exhaled ethanol for real-time analysis of ALDH2 related alcohol metabolism

A novel imaging system of ethanol in exhaled breath induced by acetaldehyde dehydrogenase (ALDH2)-related alcohol metabolism has been developed. The system provides an image of ethanol distribution as chemiluminescence (CL) on an enzyme-immobilized support. The spatiotemporal change of CL generated by ethanol in exhaled breath after oral administration of ethanol was detected by employing an electron multiplier CCD (EM-CCD) camera, illustrated and analyzed. Prior to measurement of standard gaseous ethanol and ethanol in exhaled breath, the system was optimized by investigating the enzyme-immobilized supports, concentration of substrate and pH condition of Tris-HCl buffer solution. The ethanol skin patch test, a simple method as an indicator of ALDH2, was performed on healthy volunteers. Breath samples of 5 volunteers with ALDH2 (+) and 5 volunteers with ALDH2 (-) were used for exhaled ethanol analysis. Concentration-time profiles of exhaled ethanol obtained from all volunteers were analyzed over a period of 120 min after oral administration of ethanol (0.4 g per kg body weight) in the form of beer which contains 5% of alcohol. The results obtained from the system showed that the peaks of exhaled ethanol concentrations appeared at 30 min, which was considered as a rapid ethanol absorption phase following first-order kinetics. Exhaled ethanol concentrations of volunteers with ALDH2 (+) were lower than volunteers with ALDH2 (-) and the digestion of ethanol in volunteers with ALDH2 (+) was faster than in volunteers with ALDH2 (-). The eliminations were analyzed to follow zero-order kinetics with a rate constant for each group.     

Comparison of storage stability of odorous VOCs in polyester aluminum and polyvinyl fluoride Tedlar bags

Whole air sampling using containers such as flexible bags or rigid canisters is commonly used to collect samples of volatile organic compounds (VOC) in air. The objective of this study was to compare the stability of polyester aluminum (PEA) and polyvinyl fluoride (PVF, brand name Tedlar^®) bags for gaseous VOC sampling. Eight VOC standards (benzene, toluene, p-xylene, styrene, methyl ethyl ketone, methyl isobutyl ketone, butyl acetate, and isobutyl alcohol) were placed into each bag at storage times of 0, 2, and 3 days prior to analyses by gas chromatography/mass spectrometry (GC/MS). From each bag representing each storage day, samples of 3 different mass loadings were withdrawn and analyzed to derive response factors (RF) of each chemical between the slope of the GC response (y-axis) vs. loaded mass (x-axis). The relative recoveries (RR) of VOC, if derived by dividing RF value of a given storage day by that of 0 day, varied by time, bag type, and VOC type. If the RR values after three days are compared, those of methyl isobutyl ketone were the highest with 96 (PVF) and 99% (PEA); however, the results of isobutyl alcohol were highly contrasting between the two bags with 31 and 94%, respectively. Differences in RR values between the two bag types increased with storage time, such that RR of PEA bags (88 ± 10%) were superior to those of PVF bags (73 ± 22%) after three days, demonstrating that VOC in PEA bags were more stable than in PVF bags.     

Selected ion flow tube mass spectrometry for on-line trace gas analysis in biology and medicine

Selected ion flow tube mass spectrometry, (SIFT-MS), is a technique for simultaneous real-time quantification of several trace gases in air and exhaled breath. It relies on chemical ionization of the trace gas molecules in air/breath samples introduced into helium carrier gas, using H(3)O(+), NO(+) and O(2)(+) reagent (precursor ions). Reactions between the precursor ions and the trace gas molecules proceed for an accurately defined time, the precursor and product ions being detected and counted by a downstream mass spectrometer. Absolute concentrations of trace gases in single breath exhalation can be determined by SIFT-MS down to parts-per-billion (ppb) levels, obviating sample collection into bags or onto traps. Calibration using chemical standards is not required, as the concentrations are calculated using the known reaction rate constants and measured flow rates and pressures. SIFT-MS has been used for many pilot investigations in several areas of research, especially as a non-invasive breath analysis tool to investigate physiological processes in humans and animals, for clinical diagnosis and for therapeutic monitoring. Examples of the results obtained from several such studies are outlined to demonstrate the potential of SIFT-MS for trace gas analysis of air, exhaled breath and the headspace above liquids.     

多批次肝衰竭患者呼出气体的电喷雾萃取电离质谱检测及代谢组学数据分析

采用高分辨电喷雾萃取电离质谱(EESI-MS)技术对肝衰竭患者和健康志愿者呼出气体样本进行快速检测, 结合多块偏最小二乘分析(MB-PLS)方法, 对多批次获取的呼出气体代谢数据进行统计建模分析, 并与传统的PLS方法进行比较. 结果表明, MB-PLS方法能有效消除批次差异对统计建模的影响. 此外, 利用MB-PLS模型变量VIP值对变量进行筛选, 可降低数据的冗余, 消除无关变量对模型的影响, 从而有效提高了模型的性能.     

Needle microextraction trap for on-site analysis of airborne volatile compounds at ultra-trace levels in gaseous samples

Different capillary needle trap (NT) configurations are studied and compared to evaluate the suitability of this methodology for screening in the analysis of volatile organic compounds (VOCs) in air samples at ultra-trace levels. Totally, 22 gauge needles with side holes give the best performance and results, resulting in good sampling flow reproducibility as well as fast and complete NT conditioning and cleaning. Two different types of sorbent are evaluated: a graphitized carbon (Carbopack X) and a polymeric sorbent (Tenax TA). Optimized experimental conditions were desorption in the GC injector at 300°C, no make-up gas to help the transport of the desorbed compounds to the GC column, 1 min splitless time for injection/desorption, and leaving the NT in the hot injector for about 20 min. Cross-contamination is avoided when samples containing high VOC levels (above likely breakthrough values) are evaluated. Neither carryover nor contamination is detected for storage times up to 48 h at 4°C. The method developed is applied for the analysis of indoor air, outdoor air and breath samples. The results obtained are equivalent to those obtained with other thermal desorption devices but have the advantage of using small sample volumes, being simpler, more economical and more robust than conventional methodologies used for VOC analysis in air samples.     

Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients

Exhaled aliphatic aldehydes were proposed as non-invasive biomarkers to detect increased lipid peroxidation in various diseases. As a prelude to clinical application of the multicapillary column–ion mobility spectrometry for the evaluation of aldehyde exhalation, we, therefore: (1) identified the most abundant volatile aliphatic aldehydes originating from in vitro oxidation of various polyunsaturated fatty acids; (2) evaluated emittance of aldehydes from plastic parts of the breathing circuit; (3) conducted a pilot study for in vivo quantification of exhaled aldehydes in mechanically ventilated patients. Pentanal, hexanal, heptanal, and nonanal were quantifiable in the headspace of oxidizing polyunsaturated fatty acids, with pentanal and hexanal predominating. Plastic parts of the breathing circuit emitted hexanal, octanal, nonanal, and decanal, whereby nonanal and decanal were ubiquitous and pentanal or heptanal not being detected. Only pentanal was quantifiable in breath of mechanically ventilated surgical patients with a mean exhaled concentration of 13 ± 5 ppb. An explorative analysis suggested that pentanal exhalation is associated with mechanical power—a measure for the invasiveness of mechanical ventilation. In conclusion, exhaled pentanal is a promising non-invasive biomarker for lipid peroxidation inducing pathologies, and should be evaluated in future clinical studies, particularly for detection of lung injury.     

Signals of neutropenia in human breath?

Children undergoing systemic chemotherapy often suffer from severe immunosuppression usually associated to severe neutropenia (neutrophils <?0.5 x 10⁹/l). Clinical courses during those periods range from asymptomatic to septic general conditions. Development of septic symptoms can be very fast and life-threatening. Swift detection of risk factors in those patients is therefore needed. So far no early, rapid and reliable marker or tool exists. Ion-Mobility-Spectrometry coupled with a Multi-Capillary-Column (IMS-MCC) can analyze more than 600 volatile components from exhaled air within a few minutes and hence is a potential, rapid detection-tool. As a proof of concept we measured the exhaled breath of 11 patients with neutropenia and 10 healthy controls ranging from 3 to 18 years of age at the time of measurement. Ten milliliters breath samples were taken at the outpatient clinic and analyzed with an onsite IMS-MCC (BreathDiscovery, B&S Analytik, Dortmund, Germany). Dead-space-volume was adapted to two groups (small 250 ml, large 500 ml). Interestingly 59 differing peaks were measured. Eleven were significantly different (p?≤?0.05), three of which highly significant (p?≤?0.01) in Mann-Whitney-Rank-Sum-testing. The corresponding analytes used in the decision tree are 2-Propanol, D-Limonene and Acetone. The analytes with the lowest rank sum identified are 2-Hexanone, Iso-Propylamine and 1-Butanol. Eventually we were able to show a three-step-decision-tree, which discerns the 21 samples except one from each group. Sensitivity was 90 % and specificity was 91 %. Naturally these findings need further confirmation within a bigger population. Our pilot-study proves that Ion-Mobility-Spectrometry coupled with a Multi-Capillary-Column is a feasible rapid diagnostic tool in the setting of a pediatric oncology out-patient clinic for patients 3 years and older. Our first results furthermore encourage additional analysis as to whether patients at risk for septic events during immunosuppression can be diagnosed in advance by rapidly assessing risk factors such as Neutropenia in exhaled breath.