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Quantification of Volatile Aldehydes Deriving from In Vitro Lipid Peroxidation in the Breath of Ventilated Patients
Authors:Lukas Martin Müller-Wirtz  Daniel Kiefer  Sven Ruffing  Timo Brausch  Tobias Hüppe  Daniel I Sessler  Thomas Volk  Tobias Fink  Sascha Kreuer  Felix Maurer
Institution:1.CBR—Center of Breath Research, Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Medical Center, Homburg, 66421 Saarland, Germany; (D.K.); (S.R.); (T.B.); (T.H.); (T.V.); (T.F.); (S.K.); (F.M.);2.Outcomes Research Consortium, Cleveland, OH 44195, USA;3.Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, USA
Abstract: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.
Keywords:anesthesia  breath analysis  mechanical ventilation  lipid peroxidation  biomarker  volatile aldehydes  pentanal  MCC–  IMS  ventilator-induced lung injury  volatile organic compounds
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