Exhaled breath condensate collection in the mechanically ventilated patient Journal Article

Authors: Carter, S. R.; Davis, C. S.; Kovacs, E. J.
Article Title: Exhaled breath condensate collection in the mechanically ventilated patient
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[NON-BREAKING SPACE]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[NON-BREAKING SPACE]degreesC to -80[NON-BREAKING SPACE]degreesC 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. Copyright Copyright 2012 Elsevier Ltd. All rights reserved.
Journal Title: Respiratory medicine
Volume: 106
Issue: 5
ISSN: 1532-3064; 0954-6111
Publisher: Elsevier Inc  
Journal Place: England
Date Published: 2012
Start Page: 601
End Page: 613
Language: English
Notes: ID: 12307; Record Owner: From MEDLINE, a database of the U.S. National Library of Medicine.; Status: MEDLINE; [Review]; Publishing Model: Journal available in: Print-Electronic Citation processed from: Internet; NLM Journal Code: 8908438, rme; Other ID: Source: NLM. NIHMS363210 [Available on 05/01/13] Source: NLM. PMC3314159 [Available on 05/01/13]; CAS Registry/EC Number/Name of Substance: 0 (Biological Markers). 0 (Inflammation Mediators).; Grant Number: 5T32 GM008750-12 (United States NIGMS NIH HHS), R01 AA012034 (United States NIAAA NIH HHS), T32 AA013527-08 (United States NIAAA NIH HHS), T32 AA013527-09 (United States NIAAA NIH HHS), T32 AA013527-10 (United States NIAAA NIH HHS); Electronic Date of Publication: 20120306; Entry Date: 20120524