Abstract
Background: Early and non-invasive diagnosis of common diseases is of great importance in the care of preterm infants. We hypothesized that volatile organic compounds (VOC) can be successfully measured in the neonatal incubator atmosphere.Methods: This is a feasibility study to investigate whether the discrimination of occupied and unoccupied neonatal incubators is possible by bedside measurement of volatile organic compounds (VOCs) on the neonatal intensive care unit. VOC profiles were measured in the incubator air using ion mobility spectrometry coupled to multi-capillary columns (BreathDiscovery B&S Analytik GmbH, Dortmund, Germany).Results: Seventeen incubators occupied by preterm infants (50 measurements) and nine unoccupied neonatal incubators were sampled, using 37 room air measurements as controls. Three VOC signals that allow the discrimination between occupied and unoccupied incubators were identified. The best discrimination was reached by peak P20 exhibiting a sensitivity, specificity, positive predictive value and negative predictive value of 94.0, 88.9, 97.3, and 72.3%, respectively. Use of a decision tree improved these values to 100.0, 88.9, 98.0, and 100.0%, respectively.Discussion: A bedside method that allows the characterization of VOC profiles in the neonatal incubator atmosphere using ion mobility spectrometry was established. Occupied and unoccupied incubators could be discriminated by characterizing VOC profiles. This technique has the potential to yield results within minutes. Thus, future studies are recommended to test the hypothesis that VOCs within neonatal incubators are useful biomarkers for non-invasive diagnostics in preterm neonates.
Highlights
More than one in ten infants is born prematurely [1, 2]
For analysis of neonatal incubator air, a multi-capillary column (MCC)/Ion mobility spectrometry (IMS) BreathDiscovery (B&S Analytik GmbH, Dortmund, Germany), laptop computer and a synthetic air gas bottle were placed on a metal cart
We demonstrate the feasibility of a novel technique that allows bedside measurements of volatile organic compounds (VOC) profiles using ion mobility spectrometry of the neonatal incubator atmosphere
Summary
More than one in ten infants is born prematurely [1, 2]. The risk of complications is inversely correlated with lower gestational age [3, 4]. Common complications in preterm infants are sepsis, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC) [1, 4,5,6,7,8]. Non-invasive diagnosis via detection of volatile organic compounds (VOCs) has been examined for sepsis, NEC, and BPD in several studies with promising results [10,11,12,13,14,15,16]. The most commonly used device is the electronic nose (eNose) that consists of an array of sensors, which allows to distinguish groups based on their specific so called “smell prints” [11,12,13,14,15] This method of pattern recognition does not allow the characterization and identification of possible biomarkers. We hypothesized that volatile organic compounds (VOC) can be successfully measured in the neonatal incubator atmosphere
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