Evidence map›Paper›PMID 37850212›Full record

ArticleERJ open research2023

Octane in exhaled breath to diagnose acute respiratory distress syndrome in invasively ventilated intensive care unit patients.

Laura A Hagens, Nanon F L Heijnen, Marry R Smit, Alwin R M Verschueren, Tamara M E Nijsen, Inge Geven, Cristian N Presură, Ronald Rietman, Dominic W Fenn, Paul Brinkman and 4 more

Abstract read
In one paragraph

Article in ERJ open research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Laura A HagensDepartment of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0003-4629-4465
Nanon F L HeijnenDepartment of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Marry R SmitDepartment of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Alwin R M VerschuerenSleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands.
Tamara M E NijsenSleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands.
Inge GevenSleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands.
Cristian N PresurăSleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands.
Ronald RietmanSleep and Respiratory Solutions, Philips Research, Eindhoven, The Netherlands.
Dominic W FennDepartment of Respiratory Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
Paul BrinkmanDepartment of Respiratory Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0003-4546-8478
Marcus J SchultzDepartment of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0003-3969-7792
Dennis C J J BergmansDepartment of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.ORCID https://orcid.org/0000-0002-4224-6426
Ronny M SchnabelDepartment of Intensive Care, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Lieuwe D J BosDepartment of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.ORCID https://orcid.org/0000-0003-2911-4549

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The concentration of exhaled octane has been postulated as a reliable biomarker for acute respiratory distress syndrome (ARDS) using metabolomics analysis with gas chromatography and mass spectrometry (GC-MS). A point-of-care (POC) breath test was developed in recent years to accurately measure octane at the bedside. The aim of the present study was to validate the diagnostic accuracy of exhaled octane for ARDS using a POC breath test in invasively ventilated intensive care unit (ICU) patients. Methods: This was an observational cohort study of consecutive patients receiving invasive ventilation for at least 24 h, recruited in two university ICUs. GC-MS and POC breath tests were used to quantify the exhaled octane concentration. ARDS was assessed by three experts following the Berlin definition and used as the reference standard. The area under the receiver operating characteristic curve (AUC) was used to assess diagnostic accuracy. Results: 519 patients were included and 190 (37%) fulfilled the criteria for ARDS. The median (interquartile range) concentration of octane using the POC breath test was not significantly different between patients with ARDS (0.14 (0.05-0.37) ppb) and without ARDS (0.11 (0.06-0.26) ppb; p=0.64). The AUC for ARDS based on the octane concentration in exhaled breath using the POC breath test was 0.52 (95% CI 0.46-0.57). Analysis of exhaled octane with GC-MS showed similar results. Conclusions: Octane in exhaled breath has insufficient diagnostic accuracy for ARDS. This disqualifies the use of octane as a biomarker in the diagnosis of ARDS and challenges most of the research performed up to now in the field of exhaled breath metabolomics.

Identifiers

PMID37850212
PMCPMC10577595

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.