Chest
Clinical Investigations in Critical CareExhaled Breath Condensate Nitrite and Its Relation to Tidal Volume in Acute Lung Injury
Section snippets
Patients
Inclusion criteria for this study were defined by acute respiratory failure due to pneumonia or COPD exacerbation leading to a minimum of 24 h of mechanical ventilation. After that time, patients had to be hemodynamically (no change in IV catecholamines of > 25% of baseline) and respiratory stable (no alteration in ventilator settings). A time frame of an additional 48 h was allowed to reach these criteria and to collect EBC without interference by necessary ICU procedures. Ventilator settings
EBC NO2− and Clinical Scores
EBC NO2− was significantly different in the three patient groups: EBC NO2− was increased in patients with ARDS compared to patients with ALI criteria or patients without signs of lung injury according to both AECC (ARDS, 6.28 ± 1.94 μmol/L; ALI, 4.56 ± 1.32 μmol/L; no lung injury, 3.58 ± 1.52 μmol/L) as well as LISS criteria (ARDS, 6.26 ± 1.71 μmol/L; ALI, 4.61 ± 1.70 μmol/L; no lung injury, 3.23 ± 2.07 μmol/L) [Fig 1].
EBC NO2− and Ventilatory Parameters
Table 2summarizes the correlations between EBC NO2− and ventilatory
Discussion
Nitrite, generated by nitric oxide in aqueous media, has often been regarded to be a marker of inflammation.11,26 It may therefore not have come to anyone's surprise that NO2− was observed in EBC of ventilated patients with lung injury due to pneumonia or exacerbation of COPD. At first sight, a relation of inflammation and EBC NO2− is further suggested by a (weak) correlation of lung injury scores and EBC NO2−. However, further analysis of factors influencing EBC NO2− has led us to suggest a
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