Exhaled volatile organic compounds, phospho-tau and postoperative delirium

术后妄想(POD)是常见的，尤其是在老年患者。阿尔茨海默氏症患者 阿尔茨海默病(AD)或AD相关痴呆(ADRD)有更高的神志不清风险。精神错乱患者 有更高的机会发展为AD和ADRD。已有研究表明，AD相关生物标志物，如 作为磷酸化的tau和神经丝的光，在血液中与POD有关。然而，这些测试 这需要时间，而且表演成本很高。采集血液有一个很小的风险。阿尔茨海默病患者 POD有代谢功能障碍。研究表明，在挥发性有机化合物中存在差异 AD患者与健康对照组呼出气体中挥发性有机化合物(VOCs)的研究这是不是 POD患者与非POD患者之间的情况尚不清楚。评估呼出的VOCs是 无创，可在床上使用我们的设备进行。我们假设POD患者 呼出的VOCs具有独特的模式，并且这种模式与AD相关的生物标志物相关 在血液中。为了解决这些假设，我们将招募150名65岁的脊柱手术患者。 几年或更大。他们呼出的气体将用先进的便携式气体进行分析 层析法。他们的血液将被用来分析tau，pho-tau，神经丝光和 淀粉样β蛋白多肽。将评估POD的发生率和严重程度。挥发性有机碳和血液 POD患者的生物标志物结果将与非POD患者进行比较。这个 将确定POD的VOCs和AD相关生物标志物的预测值。这些研究将 首次确定呼气VOCs的非侵入性快速分析是否可以用于 预测POD。已识别的VOCs对与患者之间的不同模式有贡献 没有POD将表明代谢途径功能失调。关联性分析 呼出的VOCs与血液中AD相关生物标志物之间的关系可能揭示 AD样神经病理和呼出的VOCs之间的关系。因此，该项目可能会提供初步的证据 VOCs在POD和AD相关神经病理中的作用。

Postoperative delirium (POD) is common, especially in elderly patients. Patients with Alzheimer’s disease (AD) or AD-related dementias (ADRD) have a higher risk of delirium. Patients with delirium have a higher chance to develop AD and ADRD. It has been shown that AD-related biomarkers, such as phospho-tau and neurofilament light, in the blood are associated with POD. However, these tests take time and are expensive to perform. Harvesting blood carries a minor risk. Patients with AD and POD have metabolic dysfunction. Studies have shown that there are differences in the volatile organic compounds (VOCs) in the exhaled gases between AD patients and healthy controls. Whether this situation exists between patients with POD and non-POD is not known. Evaluating exhaled VOCs is no-invasive and can be done at bed site with our equipment. We hypothesize that patients with POD have a unique pattern of exhaled VOCs and that this pattern is associated with AD-related biomarkers in the blood. To address these hypotheses, we will recruit 150 patients with spine surgery who are 65 years or older. Their exhaled gases will be analyzed by using advanced portable gas chromatography. Their blood will be used to analyze tau, phospho-tau, neurofilament light and amyloid beta peptides. The POD incidence and severity will be assessed. The VOC and blood biomarker results of patients with POD will be compared with those of patients without POD. The predicting values of VOCs and AD-related biomarkers for POD will be determined. These studies will for the first time determine whether a no-invasive and quick analysis of exhaled VOCs can be used to predict POD. The identified VOCs that contribute to the different patterns between patients with and without POD will indicate metabolic pathways that are dysfunctional. The analysis of the correlation between exhaled VOCs and AD-related biomarkers in the blood may reveal possible relationship between AD-like neuropathology and exhaled VOCs. Thus, this project may provide initial evidence for the role of VOCs in POD and AD-related neuropathology.