Serial, Non-invasive Analysis of Exhaled Breath Condensate in Ventilated Trauma Patients

Serial, Non-invasive Molecular Analysis of Exhaled Breath Condensate to Define the Pulmonary Flora in Critically Injured, Ventilated Adults: The Clinical Trial

To determine if the analysis of exhaled breath condensate correlates with the development & resolution of pneumonia.

This proposal investigates the utility of exhaled breath condensate fluid (EBCF) collected from heat moisture exchange (HME) filters connected to patient's endotracheal tubes for early, non-invasive detection of ventilator-associated pneumonia (VAP) in critically ill or injured ICU patients. The development of pneumonia during mechanical ventilation is the most common healthcare-associated infection in severely injured patients, accounting for substantial morbidity, excess ICU and hospital stay, additional cost and increased mortality.

Inclusion Criteria:

• Age 18 or older
• Admitted to the Vanderbilt Trauma (TICU) and Surgical Intensive Care Units (SICU)
• Mechanically ventilated for ≥2 successive days (without planned extubation within 24 hours of enrollment)

Exclusion Criteria:

• Less than 18 years of age
• Expected survival less than 24 hours
• Anticipated extubation within 24 hours of enrollment
• Conditions limiting the subject's ability to tolerate collection of lavage specimens, including: FIO2 > 80%; PEEP > 16 cmH2O; Intracranial pressure >20 cmH2O; Tracheal or mucosal bleeding; Platelet count < 20,000 cells/uL; INR > 2.0
• Known prisoners
• Pneumonia diagnosis at the time of ICU admission