Muller W G, Morini F, Eaton S, Peters M, Jaffe A
Portex Anaesthesia, Intensive Therapy and Respiratory Medicine Unit, Great Ormond Street Hospital for Children National Health Service Trust, London, UK.
Eur Respir J. 2006 Sep;28(3):479-85. doi: 10.1183/09031936.06.00063505. Epub 2006 Apr 26.
The aim of this study was to develop a technique for the collection of exhaled breath condensate (EBC) from ventilated children and assess its safety and feasibility. Collection of EBC is used to investigate markers of oxidative stress in the lower airway. No studies have assessed its safety in ventilated children. An in vitro model was developed by connecting a ventilator to an artificial lung; 14 clinical and ventilatory parameters were measured during EBC collection from ventilated children. Levels of 8-isoprostane were measured following collection with and without humidification of the inhaled gas. Amount of water vapour collected was linearly related to time and to minute ventilation in the in vitro model. EBC collections (n = 68) were made from ventilated children. In the nonhumidified group, the mean (range) positive end-expiratory pressure increased by 4.1% (2.8-5.5%) and the peak inspiratory flow decreased by 6.1% (11.0-1.3%) during collection. Detectable levels of 8-isoprostane were only found in 10 out of 18 nonhumidified EBC samples (median (range) 4.7 pg x mL(-1) (0-5.8)). Collection of exhaled breath condensate from ventilated infants and children is feasible and safe. Discontinuation of humidification is likely to be important in standardising the measurement of inflammatory parameters in exhaled breath condensate collected from ventilated children.
本研究的目的是开发一种从接受机械通气的儿童中收集呼出气冷凝液(EBC)的技术,并评估其安全性和可行性。收集EBC用于研究下呼吸道氧化应激的标志物。尚无研究评估其在接受机械通气儿童中的安全性。通过将呼吸机与人工肺相连建立了一个体外模型;在从接受机械通气的儿童中收集EBC期间,测量了14项临床和通气参数。在吸入气体有加湿和无加湿的情况下收集EBC后,测量8-异前列腺素的水平。在体外模型中,收集的水蒸气量与时间和分钟通气量呈线性相关。从接受机械通气的儿童中收集了68份EBC样本。在未加湿组中,收集期间呼气末正压平均值(范围)增加了4.1%(2.8 - 5.5%),吸气峰流速降低了6.1%(11.0 - 1.3%)。在18份未加湿的EBC样本中,仅10份检测到8-异前列腺素(中位数(范围)4.7 pg x mL(-1)(0 - 5.8))。从接受机械通气的婴幼儿中收集呼出气冷凝液是可行且安全的。在标准化从接受机械通气儿童中收集的呼出气冷凝液中炎症参数的测量方面,停止加湿可能很重要。