HYDROGEN-PEROXIDE IN EXPIRED BREATH CONDENSATE OF PATIENTS WITH ACUTE RESPIRATORY-FAILURE AND WITH ARDS

Objective: Measurement of hydrogen peroxide concentrations in breath condensate of mechanically ventilated patients with ARDS and with risk factors for developing ARDS. Design: Open study in intensive care patients. Setting: Intensive care units of the Clinics of the University of Goettingen, a primary care center. Patients: 10 post-operatively ventilated patients as a control group and 26 patients with acute respiratory failure, 7 of them with ARDS, 12 with polytrauma, 4 with pneumonia, 3 with cardiogenic or nephrogenic pulmonary edema. Interventions: None. Measurements: Breath condensate was collected by a special cold trap and was analysed for H2O2 by a chemiluminescence method. Daily measurements were performed for 4.2+/-2.6 days (mean+/-SD) as soon as possible after manifestation of respiratory failure. Results: Patients with acute respiratory failure exhibited higher H2O2 concentrations than control patients (median 95 nmol/l, range 76 - 144 nmol/l), with the highest median value found in the ARDS group (552 nmol/l, range 154-893). After clinical improvement, H2O2 concentrations decreased to the range of the control group. Conclusion: Since high concentrations of H2O2 in breath condensate were only found in patients with ARDS or with risk factors for ARDS, the results add to the existing evidence that reactive oxygen species are associated with some acute lung diseases.