Submitted by Cassidy Connolly, SRT, Conestoga College

Acute Respiratory Distress Syndrome (ARDS) is a life-threatening condition involving a severe inflammation of the lungs.  The inflammation can be initiated by pneumonia, sepsis, trauma, or an existing illness but the extent of its causes has not been fully discovered (Mraz, 2019; Zhou, 2019). As the lungs become inflamed, fluid leaks into the alveolar sacs causing the blockage of oxygen exchange into the bloodstream. With a lack of oxygen reaching vital organs the patient will experience rapid breathing, shortness of breath, and fatigue.  The mortality rate of ARDS is as high as 40%, but even for its survivor’s, long-term deficiency in lung and neurocognitive function are to follow (Chinh, Manabe, Son et al., 2019; Zhou, 2019).  Long-term issues could be improved by earlier diagnosis, but doctors rely on time consuming and expensive determining tools with low accuracy. Previous the most used ARDS detecting tool called Lung Injury Prevention Score (LIPS) had a predictive value of only 18%, allowing for very minimal early recognition of this illness (Vatican, 2019; Zhou, 2019).  LIPS is a screening tool that uses available clinical data to detect patient risk for developing ARDS (Zhou, 2019).  However, often this tool does not allow for diagnosis early enough, causing long-term issues and sometimes fatality for the patient.

The University of Michigan has developed a small hand-held gas chromatography system that is able to detect hundreds of volatile organic compounds (VOC’s) in exhaled breath (Bilic, 2019; Paddock, 2019; Vatican, 2019).  Some VOC’s are related to inflammatory processes in the lungs, while others can detect the severity and progression of diseases such as ARDS (Zhou, 2019). This two-dimensional gas chromatography (2D GC) system works in about 30 minutes and was tested to have an overall accuracy of 87.1% (Zhou, 2019) and allows for multiple tests to be done with closely timed results.  These tests come at a price much lower than the x-rays and ultrasounds that have been previously used for detection, saving the patient and the facility money (Mraz, 2019; Zhou, 2019).  Continual testing is possible as it is a non-invasive and limitless procedure, allowing for the disease to be closely monitored.  This helps keep the recovery on track. Many of the test results showed that this 2D GC system can predict ARDS progression anywhere from 12-48 hours in advance allowing for quick treatments and earlier release from the hospital (Zhou, 2019).  Using the previous system, costs could be anywhere from $7000 to $11 000 per day for the use of an intensive care unit, with an additional $1500 per day for the use of mechanical ventilation (Zhou, 2019).

This new technology for detecting ARDS will greatly improve the treatment and overall care of the patient.  It will speed up the recovery process, providing the patient with many long-term benefits including improved lung and neurocognitive function, as well as save them thousands of dollars in fees (where healthcare costs are out-of-pocket).  The chromatography device detects VOC’s that not only sense inflammation in the lungs, but also information about other organs in the body, possibly allowing for the detection of other issues if more research is done (Zhou, 2019).  As important as this discovery was, there are still a lot more improvements that need to be made in order to save lives.  Even with this new technology, a considerable amount of long-term damage is done to a patient’s body before the diagnosis and treatment has occurred.  The next steps in research should continue towards not only early recognition of ARDS but also towards finding the causes and prevention methods of this illness to avoid lasting damage to the lungs and rest of the body.

References

Bilic, I. (2019, August 5).
Shoebox-size breath analyzer spots deadly lung disease faster, more accurately than doctors.
Retrieved from https://news.umich.edu/shoebox-size-breath-analyzer-spots-deadly-lung-disease-faster-more-accurately-than-doctors/

Chinh, L.Q., Manabe, T., Son, D.N., Chi, N.V., Fujikura, Y., Binh, N.G., et al. (2019).
Clinical epidemiology and mortality on patients with acute respiratory distress syndrome (ARDS) in Vietnam. PLoS ONE 14(8): e0221114.
Retrieved from https://doi.org/10.1371/journal.pone.0221114

Paddock, C. (2019, August 6).
Portable breath monitor quickly detects life threatening lung disease.
Retrieved from https://www.medicalnewstoday.com/articles/325964.php

Mraz, S. (2019, August 2).
Portable breath analyzer spots deadly lung disease faster than doctors. (2019). Machine Design, 91(9), 23–24.
Available from https://www.machinedesign.com/mechanical/portable-breath-analyzer-spots-deadly-lung-disease-faster-doctors

Vatican, J. (2019, August 7).
Lung disease diagnosis:  New ARDS breath analyzer shows promise.
Retrieved from https://www.medicaldaily.com/lung-disease-diagnosis-new-breath-analyzer-shows-promise-440470

Zhou, M., Sharma, R., Zhu, H., Li, Z., Li, J., Wang, S., et al. (2019).
Rapid breath analysis for acute respiratory distress syndrome diagnostics using a portable two-dimensional gas chromatography device. Analytical and Bioanalytical Chemistry, 411(24), 6435–6447. doi: 10.1007/s00216-019-02024-5.
Available from https://link.springer.com/article/10.1007/s00216-019-02024-5

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