2016 Volume 47 Issue 6 Pages 421-429
Recent advances in instrumental chemical analysis have revealed that human body odor consists of numerous kinds of volatile organic and inorganic gases, some of which are associated with diseases, physical conditions, and physiological changes. This study focused on ammonia emanating from the body of severe burn patients as a potential biomarker for the physical and/or physiological status of patients during critical care. We measured ammonia levels in indoor air at the burn unit in Tokai University Hospital in the proximity of four severe flame burn patients, whose burn areas ranged from 50% to 83% of the total body surface area, using a passive air sampler and ion chromatography. The sampling position in the unit was decided in advance based on simulation results for the ammonia distribution calculated using computational fluid dynamics. In four cases, the indoor air concentration of ammonia in the unit varied widely over time after hospital admission ; it increased to several tens or hundreds of μg per m3 after surgical operations, including debridement to remove necrotic tissue and skin grafting, and decreased to background levels (3.6μg/m3) when the wound was closed. However, the levels remained higher than background levels after patient death. These results suggest that the status of severe burn patients can be monitored based on the indoor air concentration of ammonia in the intensive care unit.
