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Continuous exhaled breath carbon isotope analysis for early detection of sepsis
Author(s) -
Butz Daniel Elmer,
Morello Samantha L,
Sand Jordan,
Boriosi Juan P,
Holland G. Neil,
Cook Mark E
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.868.5
Subject(s) - sepsis , medicine , exhaled breath condensate , blood pressure , respiratory rate , venous blood , heart rate , ventilation (architecture) , cardiology , anesthesia , oxygen saturation , biomarker , oxygen , chemistry , mechanical engineering , organic chemistry , asthma , engineering , biochemistry
Approximately 750,000 people develop sepsis each year with more than 215,000 deaths. Earlier diagnosis and treatment of sepsis is critical to improving outcome. The exhaled breath delta value (i.e. 13 CO 2 / 12 CO 2 ratio) is a biomarker for the acute phase response (APR) to endotoxin. The objective of this study was to demonstrate that the breath delta value is a leading marker for the onset of infection in a porcine sepsis model. Sepsis was induced by cecal ligation and puncture. Briefly, pigs were anesthetized and positive pressure ventilation was established. The animal was instrumented for invasive blood pressure monitoring, cardiac output measurements, and blood sampling. Heart rate, respiratory rate, arterial blood pressure, central venous pressure, blood oxygen saturation, temperature, blood glucose, end tidal CO 2 , and breath delta value were monitored once every 15 minutes. Sepsis caused an increase in body temperature between 6 and 15 hours after onset. Other physiological parameters did not change from baseline until vascular hypotension was observed and cardiac parameters deteriorated. The breath delta value decreased from baseline 6 to 10 hours after onset and preceded changes in body temperature, cardiac and vascular parameters by a minimum of 4 hours. These data show that the breath delta value is a leading indicator of infection in peritoneal sepsis when compared to other physiological parameters. Research supported by a Wisconsin Innovation and Economic Development Research Grant.