Arasaradnam, Ramesh P., Kho, Ling, McFarlane, Michael, Wurie, Subiatu, O'Connell, Nicola, Savage, Richard S., Nwokolo, Chuka U., Bardhan, Karna D. and Covington, James A. (2015) Mo1019 : Breathomics - distinguishing minimal from overt hepatic encephalopathy by volatile organic compound detection in breath : a pilot study. Gastroenterology, 148 (4). S-1064. doi:10.1016/S0016-5085(15)33638-6

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Abstract

: Hepatic encephalopathy (HE) is a neurological manifestation of decompensated
liver disease. It develops in approximately 50% of cirrhotic patients. The current challenge
with the diagnosis of Hepatic encephalopathy is distinguishing those with minimal HE as
opposed to the more clinically apparent covert and overt HE. Rifaximin, licensed for overt
HE, is an effective therapy for these more easily diagnosed patients, but earlier identification
and treatment of HE could prevent liver disease progression and hospitalisation. We conducted
a pilot study to analyse the breath samples of patients with different HE grades,
alongside the breath of healthy controls, using a portable type electronic nose (uvFAIMS).
Methods: 42 patients were enrolled; 22 with HE and 20 healthy controls. Breath samples
were captured at the bedside using a Warwick designed breath capture device. The samples
were then analysed using a ultra violet FAIMS machine. This uses ultra violet light to energise
electrons rather than ionising radiation in the traditional FAIMS devices. West Haven criteria
were applied and MELD scores calculated. Results: Applying linear discriminant analysis,
we could distinguish those with HE from controls with a sensitivity and specificity of 95%
respectively. Minimal HE was distinguishable from covert/overt HE with sensitivity of 75%
and specificity of 50% Conclusions: This pilot study has affirmed the potential of breath
analysis to identify VOCs signatures in HE patients. Importantly this was performed utilising
a non-invasive, portable bedside device and holds potential for future early diagnosis of
minimal or covert HE.

Item Type:	Journal Article
Divisions:	Faculty of Science > Engineering
Journal or Publication Title:	Gastroenterology
Publisher:	W.B. Saunders Co.
ISSN:	0016-5085
Official Date:	2015
Volume:	148
Number:	4
Page Range:	S-1064
Identifier:	10.1016/S0016-5085(15)33638-6
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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