ReCIVA breath sampling in pediatric asthma: a feasibility study

Introduction: Diagnosing asthma in children is challenging and no gold standard diagnostic test exists. Novel non-invasive breathanalysis approaches could assist in diagnosis and phenotyping of children with asthma. In the EMBERclinical trial, a ReCIVA breathsampling device was used for bedside breathcollection to carry out advanced metabolomics studies. Our aim was to evaluate the feasibility of this breathsampling technology in children. Methods: Samples were taken from children attending hospital with either an acute exacerbation of asthma or stable chronic asthma, and healthy controls. They breathedinto the ReCIVA sampler tidally for a maximum of 900s. Two samples were collected for each subject on thermal desorptiontubes for analysis by gas chromatography-mass spectrometry. A percentage of breathcollected was calculated for each child. For each breathsample, two other samples were collected to capture the environmental air and ReCIVA air supply profiles, necessary for the background subtractionprocess to identify true breathrelated endogenous compounds. Results: 51 children participated with a mean age of 11yr (range 5-16). 12 had an acute exacerbation of asthma, 30 had stable chronic asthma and 9 were controls. All tolerated the sampling process and 80% provided 100% of the target breathsampling collection. Discussion: Non-invasive breathanalysis in children of varying age with acute and chronic illnesses is feasible. Ongoing work includes a) continuing the analysis of samples and b) following metabolomics data workflow to create a breathmatrix. Statistical analysis will allow us to extract target biomarkers with the ultimate aim of improving asthma diagnosis and phenotyping in children.