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This paper presents a novel technique for extracting the alveolar part of human breath. Gas exchange occurs between blood and inhaled air in the alveoli, which is helpful in medical diagnostics based on breath analysis. Consequently, the alveolar portion of the exhaled air contains specific concentrations of endogenous EVOC (exogenous volatile organic compound), which, among other factors, depend on the person's health condition. As this part of the breath enables the screening for diseases, accurate sample collection for testing is crucial. Inaccurate sampling can significantly alter the composition of the specimen, alter the concentration of EVOC (biomarkers) and adversely affect the diagnosis. Furthermore, the volume of alveolar air is minimal (usually <350 mL), especially in the case of people affected by respiratory system problems. For these reasons, precise sampling is a key factor in the effectiveness of medical diagnostic systems. A new technique ensuring high accuracy and repeatability is presented in the article. It is based on analyzing the changes in carbon dioxide concentration in human breath using a fast and compensated non-dispersive infrared (NDIR) sensor and the simple moving adjacent average (SMAA) algorithm. Research has shown that this method accurately identifies exhalation phases with an uncertainty as low as 20 ms. This provides around 350 ms of breath duration for carrying out additional stages of the diagnostic process using various types of analyzers. [ABSTRACT FROM AUTHOR]

[Display omitted] • Newer and more effective diagnosis technologies are required by modern medicine. • Biomarkers emitted in breath have been explored as a rapid diagnosis tool. • Among the main biomarkers, Volatile Organic Compounds deserve special attention. • VOCs characteristics make them an open window to the interior of human organism. • A vast range of diseases can be assessed by their relationship with VOCs biomarkers. The analysis of volatile organic compounds (VOCs) from human matrices like breath, perspiration, and urine has received increasing attention from academic and medical researchers worldwide. These biological-borne VOCs molecules have characteristics that can be directly related to physiologic and pathophysiologic metabolic processes. In this work, gathers a total of 292 analytes that have been identified as potential biomarkers for the diagnosis of various non-carcinogenic diseases. Herein we review the advances in VOCs with a focus on breath biomarkers and their potential role as minimally invasive tools to improve diagnosis prognosis and therapeutic monitoring. [ABSTRACT FROM AUTHOR]

The analysis of exhaled breath has attracted considerable interest for use in disease diagnosis and for monitoring treatments. Mass spectrometry (MS)-based approaches have been proven to be powerful analytical tools for breath analysis in clinical applications such as disease research, diagnosis, and monitoring. This review highlights MS methodologies as potential clinical tools in diagnosing human diseases. Different breath sampling methods and MS methods for breath analysis are reviewed, emphasizing their features, advantages, and limitations. Breath biomarkers from different diseases are summarized, describing their specificity, sensitivity, and drawbacks. The future perspectives and challenges on further development of MS-based breath diagnostics are discussed. [Display omitted] • Recent advances in breath analysis by mass spectrometry are reviewed. • Clinical applications of breath diagnostics are summarized. • Challenges of breath biomarkers for disease diagnosis are highlighted. • Future perspectives on breath diagnostics in clinical applications are discussed. [ABSTRACT FROM AUTHOR]

Background: The potential of exhaled breath sampling and analysis has long attracted interest in the areas of medical diagnosis and disease monitoring. This interest is attributed to its non-invasive nature, access to an unlimited sample supply (i.e., breath), and the potential to facilitate a rapid at patient diagnosis. However, progress from laboratory setting to routine clinical practice has been slow. Different methodologies of breath sampling, and the consequent difficulty in comparing and combining data, are considered to be a major contributor to this. To fulfil the potential of breath analysis within clinical and pre-clinical medicine, standardisation of some approaches to breath sampling and analysis will be beneficial. Objectives: The aim of this review is to investigate the heterogeneity of breath sampling methods by performing an in depth bibliometric search to identify the current state of art in the area. In addition, the review will discuss and critique various breath sampling methods for off-line breath analysis. Methods: Literature search was carried out in databases MEDLINE, BIOSIS, EMBASE, INSPEC, COMPENDEX, PQSCITECH, and SCISEARCH using the STN platform which delivers peer-reviewed articles. Keywords searched for include breath, sampling, collection, pre-concentration, volatile. Forward and reverse search was then performed on initially included articles. The breath collection methodologies of all included articles was subsequently reviewed. Results: Sampling methods differs between research groups, for example regarding the portion of breath being targeted. Definition of late expiratory breath varies between studies. Conclusions: Breath analysis is an interdisciplinary field of study using clinical, analytical chemistry, data processing, and metabolomics expertise. A move towards standardisation in breath sampling is currently being promoted within the breath research community with a view to harmonising analysis and thereby increasing robustness and inter-laboratory comparisons. [ABSTRACT FROM AUTHOR]

Breath analysis is a non-invasive approach which may be applied to disease diagnosis and pharmacokinetic study. In the case of offline analysis, the exhaled gas needs to be collected and the sampling bag is often used as the storage vessel. However, the sampling bag usually releases some extra compounds, which may interfere with the result of the breath test. In this study, a novel breath sampling glass bottle was developed with a syringe needle sampling port for solid phase microextraction (SPME). Such a glass bottle scarcely liberates compounds and can be used to collect exhaled gas for ensuing analysis by gas chromatography-mass spectrometry (GC–MS). The glass bottle sampling SPME-GC–MS analysis was carried out to investigate the breath metabolites of myrtol, a multicompound drug normally used in the treatment of bronchitis and sinusitis. Four compounds, α-pinene, 2,3-dehydro-1,8-cineole, d-limonene and 1,8-cineole were found in the exhaled breath of all eight volunteers who had taken the myrtol. While for other ten subjects who had not used the myrtol, these compounds were undetectable. In the SPME-GC–MS analysis of the headspace of myrtol, three compounds were detected including α-pinene, d-limonene and 1,8-cineole. Comparing the results of breath and headspace analysis, it indicates that 2,3-dehydro-1,8-cineole in the breath is the metabolite of 1,8-cineole. It is the first time that this metabolite was identified in human breath. The study demonstrates that the glass bottle sampling SPME-GC–MS method is applicable to exhaled gas analysis including breath metabolites investigation of drugs like myrtol. [ABSTRACT FROM AUTHOR]

The ammonia odor from the exhaled breath of renal patients is associated with high levels of blood urea nitrogen. Typically, in the liver, ammonia and ammonium ions are converted into urea through the urea cycle. In the case of renal dysfunction, urea is unable to be removed and that causes a buildup of excessive ammonia. As small molecules, ammonia and ammonium ions can be forced into the blood-lung barrier and occur in exhaled breath. Therefore, people with renal failure have an ammonia (fishy) odor in their exhaled breath. Thus, exhaled breath ammonia can be a potential biomarker for monitoring renal diseases during hemodialyis. In this review, we have summarized the source of ammonia in the breath of end-stage renal disease patient, cause of renal disorders, exhaled breath condensate, and breath sampling. Further, various biosensor approaches to detect exhaled ammonia from renal patients and other ammonia systems are also discussed. We conclude with future perspectives, namely colorimetric-based real-time breathing diagnosis of renal failure, which might be useful for prospective studies. [ABSTRACT FROM AUTHOR]

Since the COVID-19 pandemic, the unprecedented use of facemasks has been requiring for wearing in daily life. By wearing facemask, human exhaled breath aerosols and inhaled environmental exposures can be efficiently filtered and thus various filtration residues can be deposited in facemask. Therefore, facemask could be a simple, wearable, in vivo , onsite and noninvasive sampler for collecting exhaled and inhalable compositions, and gain new insights into human health and environmental exposure. In this review, the recent advances in developments and applications of in vivo facemask sampling of human exhaled bacteria, viruses, proteins, and metabolites, and inhalable facemask contaminants and air pollutants, are reviewed. New features of facemask sampling are highlighted. The perspectives and challenges on further development and potential applications of facemask devices are also discussed. [Display omitted] • Facemask wearing for in vivo sampling of bacteria, viruses, proteins, and metabolites in human exhaled breath are reviewed. • Facemask wearing for in situ sampling of human inhalable pollutants from ambient air is introduced. • Composition analysis of human inhalable contaminations from facemask devices is summarized. • New features of facemask sampling are highlighted. • New perspectives and challenges on facemask sampling are discussed. [ABSTRACT FROM AUTHOR]

Abstract: The measurement of volatile chemicals in human exhalant (breath analysis) has recently emerged as a non-invasive technique with the potential for the early diagnosis of disease. A common method of volatile chemical collection is to capture gases onto a solid phase sorbent followed, at a later time, by thermal release and analysis. This technique, termed thermal desorption (TD), may be a useful means to collect and store breath volatiles in a clinical setting prior to analysis. TD is, however, normally used in conjunction with gas chromatography (TD–GC) which results in slow analysis times and the required use of chemical standards. The new technique of selected ion flow tube mass spectrometry (SIFT-MS) offers a more rapid analysis process without the need for standards. SIFT-MS is normally used to analyze gas concentration in real-time and it is unclear whether combined TD and SIFT-MS can be successfully employed for breath analysis. We found that there was an approximate 1 to 1 concordance between levels of isoprene or acetone in the breath of 12 healthy volunteers measured either using real-time SIFT-MS or offline using a combination of SIFT-MS and TD (TD–SIFT-MS). The use of higher volumes of human breath did impact TD–SIFT-MS measurements of isoprene (but not acetone) with an apparent ceiling effect being observed. Nevertheless our findings demonstrate the potential for breath analysis using a combination of TD and SIFT-MS, an approach which may find utility in a clinical setting which does not allow online analysis of breath. [Copyright &y& Elsevier]

Exhaled breath analysis for early disease detection may provide a convenient method for painless and non-invasive diagnosis. In this work, a novel, compact and easy-to-use breath analyzer platform with a modular sensing chamber and direct breath sampling unit is presented. The developed analyzer system comprises a compact, low volume, temperature-controlled sensing chamber in three modules that can host any type of resistive gas sensor arrays. Furthermore, in this study three modular breath analyzers are explicitly tested for reproducibility in a real-life breath analysis experiment with several calibration transfer (CT) techniques using transfer samples from the experiment. The experiment consists of classifying breath samples from 15 subjects before and after eating a specific meal using three instruments. We investigate the possibility to transfer calibration models across instruments using transfer samples from the experiment under study, since representative samples of human breath at some conditions are difficult to simulate in a laboratory. For example, exhaled breath from subjects suffering from a disease for which the biomarkers are mostly unknown. Results show that many transfer samples of all the classes under study (in our case meal/no meal) are needed, although some CT methods present reasonably good results with only one class. [ABSTRACT FROM AUTHOR]

Despite promising results obtained in the early diagnosis of several pathologies, breath analysis still remains an unused technique in clinical practice due to the lack of breath sampling standardized procedures able to guarantee a good repeatability and comparability of results. The most diffuse on an international scale breath sampling method uses polymeric bags, but, recently, devices named Mistral and ReCIVA, able to directly concentrate volatile organic compounds (VOCs) onto sorbent tubes, have been developed and launched on the market. In order to explore performances of these new automatic devices with respect to sampling in the polymeric bag and to study the differences in VOCs profile when whole or alveolar breath is collected and when pulmonary wash out with clean air is done, a tailored experimental design was developed. Three different breath sampling approaches were compared: (a) whole breath sampling by means of Tedlar bags, (b) the end-tidal breath collection using the Mistral sampler, and (c) the simultaneous collection of the whole and alveolar breath by using the ReCIVA. The obtained results showed that alveolar fraction of breath was relatively less affected by ambient air (AA) contaminants (p-values equal to 0.04 for Mistral and 0.002 for ReCIVA Low) with respect to whole breath (p-values equal to 0.97 for ReCIVA Whole). Compared to Tedlar bags, coherent results were obtained by using Mistral while lower VOCs levels were detected for samples (both breath and AA) collected by ReCIVA, likely due to uncorrected and fluctuating flow rates applied by this device. Finally, the analysis of all data also including data obtained by explorative analysis of the unique lung cancer (LC) breath sample showed that a clean air supply might determine a further confounding factor in breath analysis considering that lung wash-out is species-dependent. [ABSTRACT FROM AUTHOR]