Microcirculation Laboratory, Department of Bioengineering, Institute for Engineering in Medicine, University of California San Diego, La Jolla, California.
Shock. 2017 Nov;48(5):571-575. doi: 10.1097/SHK.0000000000000888.
There is a need to develop markers for early detection of organ failure in shock that can be noninvasively measured at point of care. We explore here the use of volatile organic compounds (VOCs) in expired air in a rat peritonitis shock model. Expired breath samples were collected into Tedlar gas bags and analyzed by standardized gas chromatography. The gas chromatograms were digitally analyzed for presence of peak amounts over a range of Kovach indices. Following the induction of peritonitis, selected volatile compounds were detected within about 1 h, which remained at elevated amounts over a 6 h observation period. These VOCs were not present in control animals without peritonitis. Comparisons with know VOCs indicate that they include 1,4-diaminobutane and trimethylamine N-oxide. When pancreatic digestive proteases were blocked with tranexamic acid in the intestine and peritoneum, a procedure that serves to reduce organ failure in shock, the amounts of VOCs in the breath decreased spontaneously to control values without peritonitis. These results indicate that peritonitis shock is accompanied by development of volatile organic compounds that may be generated by digestive enzymes in the small intestine. VOCs may serve as indicators for detection of early forms of autodigestion by digestive proteases.
需要开发能够在床边非侵入性测量的休克器官衰竭早期检测标志物。我们在此探索在腹膜炎休克模型中使用呼气中的挥发性有机化合物 (VOCs)。将呼出的呼吸样本收集到 Tedlar 气袋中，并通过标准化气相色谱法进行分析。气相色谱图通过数字化分析，以确定在一系列科瓦奇指数范围内存在的峰量。在诱导腹膜炎后，大约在 1 小时内检测到选定的挥发性化合物，并且在 6 小时的观察期间，这些化合物的含量仍然升高。在没有腹膜炎的对照动物中不存在这些 VOC。与已知 VOC 的比较表明，它们包括 1,4-二氨基丁烷和三甲胺 N-氧化物。当在肠和腹膜中用氨甲环酸阻断胰腺消化蛋白酶时，这一程序可用于减少休克中的器官衰竭，呼吸中的 VOC 量会自发降低至无腹膜炎的对照值。这些结果表明腹膜炎休克伴随着挥发性有机化合物的产生，这些化合物可能是小肠中的消化酶产生的。VOC 可能作为检测消化蛋白酶自发消化早期形式的指标。
