J Clin Monit Comput - Determination of breath isoprene allows the identification of the expiratory fraction of the propofol breath signal during real-time propofol breath monitoring.


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Real-time measurement of propofol in the breath may be used for routine clinical monitoring. However, this requires unequivocal identification of the expiratory phase of the respiratory propofol signal as only expiratory propofol reflects propofol blood concentrations. Determination of CO2 breath concentrations is the current gold standard for the identification of expiratory gas but usually requires additional equipment. Human breath also contains isoprene, a volatile organic compound with low inspiratory breath concentration and an expiratory concentration plateau. We investigated whether breath isoprene could be used similarly to CO2 to identify the expiratory fraction of the propofol breath signal. We investigated real-time breath data obtained from 40?study subjects during routine anesthesia. Propofol, isoprene, and CO2 breath concentrations were determined by a combined ion molecule reaction/electron impact mass spectrometry system. The expiratory propofol signal was identified according to breath CO2 and isoprene concentrations and presented as median of intervals of 30?s duration. Bland-Altman analysis was applied to detect differences (bias) in the expiratory propofol signal extracted by the two identification methods. We investigated propofol signals in a total of 3,590 observation intervals of 30?s duration in the 40 study subjects. In 51.4?% of the intervals (1,844/3,590) both methods extracted the same results for expiratory propofol signal. Overall bias between the two data extraction methods was -0.12?ppb. The lower and the upper limits of the 95?% CI were -0.69 and 0.45?ppb. Determination of isoprene breath concentrations allows the identification of the expiratory propofol signal during real-time breath monitoring.

Resumo Limpo

realtim measur propofol breath may use routin clinic monitor howev requir unequivoc identif expiratori phase respiratori propofol signal expiratori propofol reflect propofol blood concentr determin co breath concentr current gold standard identif expiratori gas usual requir addit equip human breath also contain isopren volatil organ compound low inspiratori breath concentr expiratori concentr plateau investig whether breath isopren use similar co identifi expiratori fraction propofol breath signal investig realtim breath data obtain studi subject routin anesthesia propofol isopren co breath concentr determin combin ion molecul reactionelectron impact mass spectrometri system expiratori propofol signal identifi accord breath co isopren concentr present median interv s durat blandaltman analysi appli detect differ bias expiratori propofol signal extract two identif method investig propofol signal total observ interv s durat studi subject interv method extract result expiratori propofol signal overal bias two data extract method ppb lower upper limit ci ppb determin isopren breath concentr allow identif expiratori propofol signal realtim breath monitor

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