Exhaled breath measures of inflammation: are they useful in neonatal chronic lung disease?

C M Harrison1, C C Andersen

  • 1Department of Pediatrics, Mercy Hospital for Women, Clarendon St, East Melbourne, Victoria 3002, Australia.

Insights

Inflammation contributes to lung injury in premature infants. This review examines non-invasive exhaled breath tests for monitoring pulmonary inflammation in premature newborns, highlighting their potential and need for validation.

Area of Science:

  • Neonatal Medicine
  • Pulmonary Medicine
  • Biomarkers

Background:

  • Neonatal chronic lung disease is a significant issue in extremely premature infants.
  • Inflammation is a key factor amplifying lung injury in premature lungs.
  • Current methods for assessing pulmonary inflammation are invasive, with tracheal fluid analysis as the gold standard.

Purpose of the Study:

  • To review non-invasive exhaled breath measures for assessing pulmonary inflammation in ventilated premature newborns.
  • To discuss sample collection, analysis, and potential pitfalls of these methods.
  • To evaluate their clinical applicability for infants at risk of chronic lung disease.

Main Methods:

  • Review of available literature on exhaled breath measures.
  • Focus on nitric oxide, carbon monoxide, volatile hydrocarbons, and exhaled breath condensate.
  • Consideration of application in ventilated premature neonates.

Main Results:

  • Exhaled breath measures offer a non-invasive alternative to current invasive methods.
  • Specific markers like nitric oxide and volatile hydrocarbons show potential for monitoring inflammation.
  • Challenges include standardization of sample collection and analysis for this vulnerable population.

Conclusions:

  • Exhaled breath analysis holds promise for monitoring pulmonary inflammation in premature infants.
  • Thorough validation of these non-invasive techniques is crucial before widespread clinical adoption.
  • Further research is needed to optimize methods for the specific needs of ventilated premature newborns.

Related Concept Videos

Breathing01:05

Breathing

The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
Assessment of Respiration01:23

Assessment of Respiration

The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like asthma or COPD,...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Chronic Obstructive Pulmonary Disease-I: Introduction01:20

Chronic Obstructive Pulmonary Disease-I: Introduction

Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies01:27

Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies

Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features01:24

Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features

Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...