Methodological issues of sample collection and analysis of exhaled breath
Methodological issues of sample collection and analysis of exhaled breath
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DOI：
10.1183/1025448x.00018509
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
Schubert, J.
中科院分区：
文献类型：
--
作者：
Amann, A.;Miekisch, W.;Schubert, J.
已经制定了用于测量呼出的下呼吸道一氧化氮（NO）和鼻腔一氧化氮的推荐标准化程序。对于与其他化合物有关的呼出气体取样制定类似的准则是可取的。对于此类系统性挥发性有机化合物（VOCs），建议采用二氧化碳控制采样，以确保可靠和一致的样品质量，用于受试者内部和受试者之间的比较。呼吸中挥发性有机化合物的分析有两种基本方法：实时分析和离线实验室分析，每种方法都有其独特的优势。对呼出气体的实时分析对于活性化合物和由于外界影响而迅速变化的化合物是最有希望的。呼出气体的离线实验室分析通常采用某种形式的分析物预浓缩，然后使用高分辨率气相色谱-质谱（GCMS）检测分离步骤。气相色谱法（GCMS）提供了最详细和具体的结果，用于识别呼吸中所含的挥发性有机化合物，但样品储存、预浓缩、注射和色谱分离的过程可能会限制反应性或热不稳定代谢物的检测。本章讨论了临床/医疗应用中最先进的呼气分析，介绍了目前对不同仪器和技术的方法、实施的关注，并为将无创呼吸技术引入临床实践提供了具体的标准化指导。
Recommended standardised procedures have been developed for measurement of exhaled lower respiratory nitric oxide (NO) and nasal NO. It would be desirable to develop similar guidelines for the sampling of exhaled breath related to other compounds. For such systemic volatile organic compounds (VOCs), CO2-controlled sampling is recommended to assure reliable and consistent sample quality for within-and between-subject comparisons.There are two basic approaches for analysing VOCs in breath: real-time analysis and off-line laboratory analysis, each with its particular advantages. Real-time analysis of exhaled breath is most promising for reactive compounds and for compounds that change rapidly as a function of external influence. Off-line laboratory analysis of exhaled breath generally employs some form of pre-concentration of analytes followed by a separation step using high-resolution gas chromatography-mass spectrometry (GCMS)-based detection. GCMS gives the most detailed and specific results for identifying the VOCs contained in breath, but the processes of sample storage, pre-concentration, injection and chromatographic separation may limit the detection of reactive or thermally labile metabolites.This chapter discusses the state-of-the-art analyses of exhaled breath for clinical/medical applications, presents current concerns about methods, implementation for different instruments and techniques, and provides specific guidance for standardisation to introduce noninvasive breath-based technology into clinical practice.