Exhaled breath condensate 8-isoprostane of patients with or at risk for ARDS in ventilation_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Wenbin ,  ZHOU Shujun , WANG Gui , JIN Zhaoquan , ZHU Minghui

Department of Emergency Medicine, The First People’s Hospital of Changzhou (Third Affiliated Hospital of Soochow University), Changzhou, Jiangsu 213003, P. R. China;

Corresponding?author：

ZHOU Shujun, Email: zhoushujun@czfph.com

Keywords：

Acute respiratory distress syndrome; Mechanical ventilation; Exhaled breath condensate; 8-isoprostane

DOI：

10.7507/1671-6205.201708042

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ObjectiveTo detect the concentration of 8-isoprostane (8-iso-PG) in exhaled breath condensate (EBC) of patients with or at risk for ARDS in ventilation, and investigate its clinical significance.MethodsFifty-five patients with or at risk for ARDS in ventilation admitted between February 2014 and June 2016 were recruited as an experimental group, and simultaneous 30 normal cases were recruited as a control group. Their EBC was collected with EcoScreen condenser. The EBC 8-iso-PG level of the patients between different grades of ARDS (mild, moderate, and sever) or at risk for ARDS was compared, and the correlation of EBC 8-iso-PG with the clinical indicators was analyzed.ResultsThe 8-iso-PG levels in EBC and serum of the patients with or at risk for ARDS in ventilation were higher than those in the control group [EBC: (44.83±11.58) ng/L vs. (19.47±4.06) ng/L; serum: (481.53±444.94) ng/L vs. (19.91±17.60) ng/L] (all P<0.05). The EBC 8-iso-PG of the patients with moderate ARDS (n=15) and severe ARDS (n=7) [(47.18±11.68) ng/L and (50.29±11.06) ng/L] was higher than those with mild ARDS (n=7) or at risk for ARDS (n=26) [(33.04±7.62) ng/L) and (37.17±11.08) ng/L] (all P<0.05). However EBC 8-iso-PG was not different between the patients with mild ARDS and those at risk for ARDS (P>0.05 ). The increased EBC 8-iso-PG could predict ARDS with an area under the receiver operating curve of 0.73. The EBC 8-iso-PG of the patients with or at risk for ARDS was correlated with lung injury score (r=0.418, P<0.01), PaO₂/FiO₂ (r=–0.378, P<0.05), chest radiograph scores (r=0.410, P<0.05), AaDO₂ (r=0.368, P<0.05), and APACHEⅡ score (r=0.718, P<0.05).ConclusionEBC 8-iso-PG can reflect the oxidative stress in lung of ARDS patients in ventilation, and can contribute to the diagnosis and evaluation for moderate and severe ARDS.

Citation： ZHANG Wenbin, ZHOU Shujun, WANG Gui, JIN Zhaoquan, ZHU Minghui. Exhaled breath condensate 8-isoprostane of patients with or at risk for ARDS in ventilation. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(1): 66-70. doi: 10.7507/1671-6205.201708042 Copy

1.	Vaschetto R, Corradi M, Goldoni M, et al. Sampling and analyzing alveolar exhaled breath condensate in mechanically ventilated patients: a feasibility study. J Breath Res, 2015, 9(4): 047106.
2.	張文彬, 陳建榮. 機械通氣患者呼出氣冷凝液收集的臨床安全性和可行性. 國際呼吸雜志, 2012, 32: 362-366.
3.	Montuschi P, Ragazzoni E, Valente S, et al. Validation of 8-isoprostane and prostaglandin E(2) measurements in exhaled breath condensate. Inflamm Res, 2003, 52(12): 50-507.
4.	Tacconelli S, Capone ML, Patrignani P. Measurement of 8-iso-prostaglandin F2alpha in biological fluids as a measure of lipid peroxidation. Methods Mol Biol, 2010, 644(2): 165-178.
5.	蔣云書, 陳建榮, 張文彬, 等. 急性肺損傷/急性呼吸窘迫綜合征患者呼出氣冷凝液中血管內皮生長因子 A 檢測的臨床意義. 中國呼吸與危重監護雜志, 2011, 10 :135-138.
6.	Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome (ARDS): The Berlin Definition. JAMA, 2012, 307: 2526-2533.
7.	張文彬, 陳建榮, 蔡映云. 改裝 EcoScreen 冷凝器收集機械通氣患者呼出氣冷凝液的研究. 中國呼吸與危重監護雜志, 2010, 9(4): 391-395.
8.	Murray JF, Matthay MA, Luce JM, et al. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis, 1988, 138(3): 720-723.
9.	Yin H, Havrilla CM, Gao L, et al. Mechanisms for the formation of isoprostane endoperoxides from arachidonic acid. J Biol Chem, 2003, 278(19): 16720-16725.
10.	Carpenter CT, Price PV, Christman BW. Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS. Chest, 1998, 114(6): 1653-1659.
11.	李俊英. COX-2 在急性肺損傷中的作用. 中華急診醫學雜志, 2009, 18(12): 1341-1342.

1. Vaschetto R, Corradi M, Goldoni M, et al. Sampling and analyzing alveolar exhaled breath condensate in mechanically ventilated patients: a feasibility study. J Breath Res, 2015, 9(4): 047106.
2. 張文彬, 陳建榮. 機械通氣患者呼出氣冷凝液收集的臨床安全性和可行性. 國際呼吸雜志, 2012, 32: 362-366.
3. Montuschi P, Ragazzoni E, Valente S, et al. Validation of 8-isoprostane and prostaglandin E(2) measurements in exhaled breath condensate. Inflamm Res, 2003, 52(12): 50-507.
4. Tacconelli S, Capone ML, Patrignani P. Measurement of 8-iso-prostaglandin F2alpha in biological fluids as a measure of lipid peroxidation. Methods Mol Biol, 2010, 644(2): 165-178.
5. 蔣云書, 陳建榮, 張文彬, 等. 急性肺損傷/急性呼吸窘迫綜合征患者呼出氣冷凝液中血管內皮生長因子 A 檢測的臨床意義. 中國呼吸與危重監護雜志, 2011, 10 :135-138.
6. Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome (ARDS): The Berlin Definition. JAMA, 2012, 307: 2526-2533.
7. 張文彬, 陳建榮, 蔡映云. 改裝 EcoScreen 冷凝器收集機械通氣患者呼出氣冷凝液的研究. 中國呼吸與危重監護雜志, 2010, 9(4): 391-395.
8. Murray JF, Matthay MA, Luce JM, et al. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis, 1988, 138(3): 720-723.
9. Yin H, Havrilla CM, Gao L, et al. Mechanisms for the formation of isoprostane endoperoxides from arachidonic acid. J Biol Chem, 2003, 278(19): 16720-16725.
10. Carpenter CT, Price PV, Christman BW. Exhaled breath condensate isoprostanes are elevated in patients with acute lung injury or ARDS. Chest, 1998, 114(6): 1653-1659.
11. 李俊英. COX-2 在急性肺損傷中的作用. 中華急診醫學雜志, 2009, 18(12): 1341-1342.

Chinese Journal of Respiratory and Critical Care Medicine

Exhaled breath condensate 8-isoprostane of patients with or at risk for ARDS in ventilation

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