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Exhaled breath condensate collection in the mechanically ventilated patient. Respir Med 2012 May;106(5):601-13

Date

03/09/2012

Pubmed ID

22398157

Pubmed Central ID

PMC3314159

DOI

10.1016/j.rmed.2012.02.003

Scopus ID

2-s2.0-84859106498   24 Citations

Abstract

Collection of exhaled breath condensate (EBC) is a non-invasive means of sampling the airway-lining fluid of the lungs. EBC contains numerous measurable mediators, whose analysis could change the management of patients with certain pulmonary diseases. While initially popularized in investigations involving spontaneously breathing patients, an increasing number of studies have been performed using EBC in association with mechanical ventilation. Collection of EBC in mechanically ventilated patients follows basic principles of condensation, but is influenced by multiple factors. Effective collection requires selection of a collection device, adequate minute ventilation, low cooling temperatures, and sampling times of greater than 10 min. Condensate can be contaminated by saliva, which needs to be filtered. Dilution of samples occurs secondary to distilled water in vapors and humidification in the ventilator circuit. Dilution factors may need to be employed when investigating non-volatile biomarkers. Storage and analysis should occur promptly at -70 °C to -80 °C to prevent rapid degradation of samples. The purpose of this review is to examine and describe methodologies and problems of EBC collection in mechanically ventilated patients. A straightforward and safe framework has been established to investigate disease processes in this population, yet technical aspects of EBC collection still exist that prevent clinical practicality of this technology. These include a lack of standardization of procedure and analysis of biomarkers, and of normal reference ranges for mediators in healthy individuals. Once these procedural aspects have been addressed, EBC could serve as a non-invasive alternative to invasive evaluation of lungs in mechanically ventilated patients.

Author List

Carter SR, Davis CS, Kovacs EJ

Author

Christopher Stephen Davis MD, MPH Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Biomarkers
Breath Tests
Equipment Design
Exhalation
Humans
Inflammation Mediators
Respiration, Artificial
Specimen Handling
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