Analyze breath to monitor health status live in intensive care

Analyze breath to monitor health status live in intensive care
Analyze breath to monitor health status live in intensive care

Bern (ots)

A special bag is enough to collect the air exhaled by hospitalized children. Scientists were able to monitor young diabetics with this new non-invasive method.

“Blow the balloon, please!” What is done at roadside checks could be generalized in hospitals, particularly in intensive care. Not to measure blood alcohol levels, but to be able to monitor the state of health of patients in real time and control the level of certain medications. With the support of the Swiss National Science Foundation (SNSF), scientists from the University of Basel and the University Children’s Hospital Basel (UKBB) have developed a technique for measuring certain parameters directly in the air exhaled by patients. Their results have just been published in the journal Frontiers in Endocrinology

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The same principle as with sniffer dogs

A comparison showed that monitoring by breath sampling was as reliable as the blood tests that are usually carried out. Children hospitalized in intensive care following diabetic ketoacidosis – a potentially fatal complication of diabetes if not quickly treated – were monitored during their treatment. To monitor the evolution of symptoms and the effect of treatment, the medical team used the air exhaled by the children in addition to blood and urine samples. “The values ​​in the air perfectly reflected those measured in the blood!” enthuses Pablo Sinues, professor at the University of Basel and head of a research group on breathing in translational medicine.

The analysis works on the same principle as that which allows dogs to be trained to detect certain diseases. “We exhale with carbon dioxide small quantities of many other things present in the blood,” indicates the researcher. We therefore find in the exhaled air both the drugs administered and molecules which reflect the activity of the body, the metabolites.

Results in less than a quarter of an hour

With his colleagues, Pablo Sinues has developed respiratory analyzes in recent years to measure concentrations and adapt the dosage of antiepileptic treatments in children. But the method, which involved blowing directly into the machine in the laboratory, could not be used in intensive care or operating theaters. From now on, patients no longer need to leave their beds: the team has developed special bags in which up to 1.2 liters of exhaled air is captured. The bags, which look like simple plastic bags, are then taken directly to the laboratory to be connected to a chemical analyzer, a mass spectrometer. This device is also used with blood samples, but sample processing is complicated and takes many hours. While the air can be injected directly into the machine from the bags, without prior preparation, less than a quarter of an hour after being collected. Only routine blood tests can be completed in such a time frame.

Thanks to this speed and the possibility of easily increasing the frequency of respiratory samples, scientists were able to deepen their knowledge of the processes at work in the body during the stabilization of patients in real time. “With this very sensitive technique, we detected a wide range of compounds. Our results go beyond what has already been described.” Pablo Sinues is already planning: “We now have to sort everything out.” For example, differences between children hospitalized for the first time and others who returned regularly could be observed. These results, obtained on only five children with diabetic ketoacidosis, must still be confirmed by other studies.

A start-up already founded

Breath analysis could be used beyond diabetes. It allows the concentration of a drug and the body’s response to be measured simultaneously. Scientists hope to soon be able to integrate it into standard intensive care care. “The fact that it is non-invasive is also very practical, particularly with children,” notes Pablo Sinues. “We could use it to predict responses to treatments or side effects.” This information is particularly important when the therapeutic margins are narrow, that is to say when the drug becomes toxic if it is slightly overdosed.

“The method has proven itself with antiepileptic drugs. It could be developed to measure certain anticancer treatments. And the bags that we are currently developing would be very useful for controlling the doses and effects of anesthetics during operations,” concludes the researcher. . A start-up from his laboratory is already trying to meet these challenges.

M. Awchi et al.: Metabolic trajectories of diabetic ketoacidosis onset described by breath analysis. Frontiers in Endocrinology (2024).

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Encourage the next generation

This project was supported by the Eccellenza instrument of the SNSF. Eccellenza grants encourage young scientists who hold an assistant professorship or an equivalent position and who intend to obtain a permanent professorship. Leading a large-scale project and a team within a higher education institution in Switzerland will allow them to achieve this goal.

Eccellenza

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The text of this press release, an image to download and further information are available on the website of the Swiss National Science Foundation.
Contact:
Pablo Sinues;
Department of Biomedical Engineering,
University of Basel;
University Children’s Hospital Basel (UKBB);
Spitalstrasse 33,
CH-4056 Basel;

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