PMID- 33929393
OWN - NLM
STAT- MEDLINE
DCOM- 20210727
LR  - 20230721
IS  - 1526-7598 (Electronic)
IS  - 0003-2999 (Linking)
VI  - 133
IP  - 1
DP  - 2021 Jul 1
TI  - Volutrauma Increases Exhaled Pentanal in Rats: A Potential Breath Biomarker for 
      Ventilator-Induced Lung Injury.
PG  - 263-273
LID - 10.1213/ANE.0000000000005576 [doi]
AB  - BACKGROUND: Mechanical ventilation injures lungs, but there are currently no 
      reliable methods for detecting early injury. We therefore evaluated whether 
      exhaled pentanal, a lipid peroxidation product, might be a useful breath 
      biomarker for stretch-induced lung injury in rats. METHODS: A total of 150 male 
      Sprague-Dawley rats were investigated in 2 substudies. The first randomly 
      assigned 75 rats to 7 hours of mechanical ventilation at tidal volumes of 6, 8, 
      12, 16, and 20 mL.kg-1. The second included 75 rats. A reference group was 
      ventilated at a tidal volume of 6 mL.kg-1 for 10 hours 4 interventional groups 
      were ventilated at a tidal volume of 6 mL.kg-1 for 1 hour, and then for 0.5, 1, 
      2, or 3 hours at a tidal volume of 16 mL.kg-1 before returning to a tidal volume 
      of 6 mL.kg-1 for additional 6 hours. Exhaled pentanal was monitored by 
      multicapillary column-ion mobility spectrometry. The first substudy included 
      cytokine and leukocyte measurements in blood and bronchoalveolar fluid, 
      histological assessment of the proportion of alveolar space, and measurements of 
      myeloperoxidase activity in lung tissue. The second substudy included 
      measurements of pentanal in arterial blood plasma, cytokine and leukocyte 
      concentrations in bronchoalveolar fluid, and cleaved caspase 3 in lung tissue. 
      RESULTS: Exhaled pentanal concentrations increased by only 0.5 ppb.h-1 (95% 
      confidence interval [CI], 0.3-0.6) when rats were ventilated at 6 mL.kg-1. In 
      contrast, exhaled pentanal concentrations increased substantially and roughly 
      linearly at higher tidal volumes, up to 3.1 ppb.h-1 (95% CI, 2.3-3.8) at tidal 
      volumes of 20 mL.kg-1. Exhaled pentanal increased at average rates between 1.0 
      ppb.h-1 (95% CI, 0.3-1.7) and 2.5 ppb.h-1 (95% CI, 1.4-3.6) after the onset of 16 
      mL.kg-1 tidal volumes and decreased rapidly by a median of 2 ppb (interquartile 
      range [IQR], 0.9-3.2), corresponding to a 38% (IQR, 31-43) reduction when tidal 
      volume returned to 6 mL.kg-1. Tidal volume, inspiratory pressure, and mechanical 
      power were positively associated with pentanal exhalation. Exhaled and plasma 
      pentanal were uncorrelated. Alveolar space decreased and inflammatory markers in 
      bronchoalveolar lavage fluid increased in animals ventilated at high tidal 
      volumes. Short, intermittent ventilation at high tidal volumes for up to 3 hours 
      increased neither inflammatory markers in bronchoalveolar fluid nor the 
      proportion of cleaved caspase 3 in lung tissue. CONCLUSIONS: Exhaled pentanal is 
      a potential biomarker for early detection of ventilator-induced lung injury in 
      rats.
CI  - Copyright (c) 2021 International Anesthesia Research Society.
FAU - Muller-Wirtz, Lukas Martin
AU  - Muller-Wirtz LM
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Kiefer, Daniel
AU  - Kiefer D
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Maurer, Felix
AU  - Maurer F
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Floss, Maximilian Alexander
AU  - Floss MA
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Doneit, Jonas
AU  - Doneit J
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Huppe, Tobias
AU  - Huppe T
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Shopova, Theodora
AU  - Shopova T
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Wolf, Beate
AU  - Wolf B
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Sessler, Daniel I
AU  - Sessler DI
AD  - Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, 
      Cleveland, Ohio.
FAU - Volk, Thomas
AU  - Volk T
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Kreuer, Sascha
AU  - Kreuer S
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
FAU - Fink, Tobias
AU  - Fink T
AD  - From the CBR - Center of Breath Research, Department of Anaesthesiology, 
      Intensive Care and Pain Therapy, Saarland University Medical Center and Saarland 
      University Faculty of Medicine, Homburg, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
RN  - 0 (Aldehydes)
RN  - 0 (Anesthetics, Inhalation)
RN  - 0 (Biomarkers)
RN  - 38LVP0K73A (Sevoflurane)
RN  - B975S3014W (pentanal)
SB  - IM
MH  - Aldehydes/analysis/*metabolism
MH  - Anesthetics, Inhalation/administration & dosage
MH  - Animals
MH  - Biomarkers/metabolism
MH  - Bronchoalveolar Lavage Fluid/chemistry
MH  - Exhalation/drug effects/*physiology
MH  - Male
MH  - Rats
MH  - Rats, Sprague-Dawley
MH  - Respiration, Artificial/*adverse effects
MH  - Sevoflurane/administration & dosage
MH  - Tidal Volume/drug effects/physiology
MH  - Ventilator-Induced Lung Injury/etiology/*metabolism
COIS- The authors declare no conflicts of interest.
EDAT- 2021/05/01 06:00
MHDA- 2021/07/28 06:00
CRDT- 2021/04/30 12:18
PHST- 2021/05/01 06:00 [pubmed]
PHST- 2021/07/28 06:00 [medline]
PHST- 2021/04/30 12:18 [entrez]
AID - 00000539-202107000-00033 [pii]
AID - 10.1213/ANE.0000000000005576 [doi]
PST - ppublish
SO  - Anesth Analg. 2021 Jul 1;133(1):263-273. doi: 10.1213/ANE.0000000000005576.