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Breathomics—exhaled volatile organic compound analysis to detect hepatic encephalopathy : a pilot study

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Arasaradnam, Ramesh P., McFarlane, Michael J., Ling, K., Wurie, S., O’Connell, N., Nwokolo, Chuka U., Bardhan, Karna Dev, Skinner, J., Savage, Richard S. and Covington, James A. (2016) Breathomics—exhaled volatile organic compound analysis to detect hepatic encephalopathy : a pilot study. Journal of Breath Research, 10 (1). pp. 1-6. 016012. doi:10.1088/1752-7155/10/1/016012

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Official URL: http://dx.doi.org/10.1088/1752-7155/10/1/016012

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Abstract

he current diagnostic challenge with diagnosing hepatic encephalopathy (HE) is identifying those with minimal HE as opposed to the more clinically apparent covert/overt HE. Rifaximin, is an effective therapy but earlier identification and treatment of HE could prevent liver disease progression and hospitalization. Our pilot study aimed to analyse breath samples of patients with different HE grades, and controls, using a portable electronic (e) nose. 42 patients were enrolled; 22 with HE and 20 controls. Bedside breath samples were captured and analysed using an uvFAIMS machine (portable e-nose). West Haven criteria applied and MELD scores calculated. We classify HE patients from controls with a sensitivity and specificity of 0.88 (0.73-0.95) and 0.68 (0.51-0.81) respectively, AUROC 0.84 (0.75-0.93). Minimal HE was distinguishable from covert/overt HE with sensitivity of 0.79 and specificity of 0.5, AUROC 0.71 (0.57-0.84). This pilot study has highlighted the potential of breathomics to identify VOCs signatures in HE patients for diagnostic purposes. Importantly this was performed utilizing a non-invasive, portable bedside device and holds potential for future early HE diagnosis.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Research Centres > Centre for Complexity Science
Faculty of Science, Engineering and Medicine > Engineering > Engineering
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Research Centres > Warwick Systems Biology Centre
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Hepatic encephalopathy, Volatile organic compounds
Journal or Publication Title: Journal of Breath Research
Publisher: Institute of Physics Publishing Ltd.
ISSN: 1752-7163
Official Date: 11 February 2016
Dates:
DateEvent
11 February 2016Published
13 January 2016Accepted
26 April 2015Submitted
Volume: 10
Number: 1
Number of Pages: 6
Page Range: pp. 1-6
Article Number: 016012
DOI: 10.1088/1752-7155/10/1/016012
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access

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