HS-GC–MS analysis of volatile organic compounds after hyperoxia-induced oxidative stress: a validation study

Thijs A. Lilien, Dominic W. Fenn, Paul Brinkman, Laura A. Hagens, Marry R. Smit, Nanon F. L. Heijnen, Job B. M. van Woensel, Lieuwe D. J. Bos, Reinout A. Bem, on behalf of the DARTS study group

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Background: Exhaled volatile organic compounds (VOCs), particularly hydrocarbons from oxidative stress-induced lipid peroxidation, are associated with hyperoxia exposure. However, important heterogeneity amongst identified VOCs and concerns about their precise pathophysiological origins warrant translational studies assessing their validity as a marker of hyperoxia-induced oxidative stress. Therefore, this study sought to examine changes in VOCs previously associated with the oxidative stress response in hyperoxia-exposed lung epithelial cells. Methods: A549 alveolar epithelial cells were exposed to hyperoxia for 24 h, or to room air as normoxia controls, or hydrogen peroxide as oxidative-stress positive controls. VOCs were sampled from the headspace, analysed by gas chromatography coupled with mass spectrometry and compared by targeted and untargeted analyses. A secondary analysis of breath samples from a large cohort of critically ill adult patients assessed the association of identified VOCs with clinical oxygen exposure. Results: Following cellular hyperoxia exposure, none of the targeted VOCs, previously proposed as breath markers of oxidative stress, were increased, and decane was significantly decreased. Untargeted analysis did not reveal novel identifiable hyperoxia-associated VOCs. Within the clinical cohort, three previously proposed breath markers of oxidative stress, hexane, octane, and decane had no real diagnostic value in discriminating patients exposed to hyperoxia. Conclusions: Hyperoxia exposure of alveolar epithelial cells did not result in an increase in identifiable VOCs, whilst VOCs previously linked to oxidative stress were not associated with oxygen exposure in a cohort of critically ill patients. These findings suggest that the pathophysiological origin of previously proposed breath markers of oxidative stress is more complex than just oxidative stress from hyperoxia at the lung epithelial cellular level.
Original languageEnglish
Article number14
JournalIntensive Care Medicine Experimental
Issue number1
Publication statusPublished - 1 Dec 2024


  • Headspace gas chromatography–mass spectrometry
  • Hyperoxia
  • Intensive care unit
  • Mechanical ventilation
  • Oxidative stress
  • Volatile organic compounds

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