Abstract
Volatile organic compounds (VOCs) detected in human breath, urine, stool, sweat, saliva, and blood result from metabolic processes in the body during health or disease. Using sophisticated measurement systems, small amounts of these compounds can be detected in the above bodily fluids. Multiple studies in adults and children have shown the potential of these compounds to differentiate between healthy individuals and patients by detecting profiles of compounds in non-invasively collected samples. However, the detection of biomarkers in VOCs from neonates is particularly attractive due to the non-invasive nature of its approach, and its ability to track disease progress by longitudinal sampling. In this work we have reviewed the literature on the use of VOCs in neonates and identified areas for future work. Overview of VOCs and their usefulness as metabolic signatures. Detailed review of studies on VOCs in neonates Learn about potential uses of VOCs as derived from adult and paediatric studies. Examine current limitations and identify future work. Detailed studies on VOCs involving neonatal patients including sick preterm infants and term infants with specific morbidities are needed. These studies should collect longitudinal samples using non-invasive methods for the detection of potential biomarkers. Underlying metabolic processes need to be identified so that any therapeutic options can be clarified.
Highlights
Sick newborn infants admitted to a neonatal intensive care unit (NICU) need close continuous monitoring throughout the length of their stay
Another strategy to reduce invasive tests on neonates includes the use of urine, stool and exhaled breath as sources for volatile organic compounds (VOCs) and metabolic end products, which may be useful as biomarkers
While this paper demonstrates the sensitivity of the gas chromatography (GC)–mass spectrometry (MS) method to detect individual VOCs, using blood-samples makes it an invasive process
Summary
Sick newborn infants admitted to a neonatal intensive care unit (NICU) need close continuous monitoring throughout the length of their stay. They are subjected to multiple phlebotomy episodes and other invasive investigations for diagnostic and monitoring purposes. Long term impacts of neonatal care include mental health problems, including phobias [6], which may be related to their experiences as inpatients The burden of these problems are significant and the incidence of NICU admissions is increasing in the USA [7] and the UK. Transcutaneous bilirubin measurements for screening neonates has been in use for several years which has potential for reducing invasive blood tests [13]. Another strategy to reduce invasive tests on neonates includes the use of urine, stool and exhaled breath as sources for volatile organic compounds (VOCs) and metabolic end products, which may be useful as biomarkers
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