The proton transfer reaction mass spectrometer and its use in medical science: applications to drug assays and the monitoring of bacteria

Proton transfer reaction mass spectrometry (PTR-MS) enables monitoring of trace gases in air with high sensitivity without major gases interfering. In this paper, we present the potential use of a proton transfer reaction mass spectrometer for two medical applications; the monitoring of drugs and bacterial infection. The first study illustrates a feasibility trial to monitor the intravenous anaesthetic agent 2,6-di-isopropyl phenol (propofol), and two of its metabolites, on the breath of patients in real-time during surgery. Propofol is a commonly used intravenous anaesthetic. However, there is no method of instantaneously monitoring the plasma concentration of the agent during surgery, and therefore determining whether or not the plasma level is of such a value to ensure that the patient is correctly anaesthetized. That propofol and its metabolites were monitored in real-time using the PTR-MS suggests possibilities for routine intravenous anaesthesia monitoring analogous to that for volatile anaesthetic agents. In addition to the above work we also investigated proton transfer to another anaesthetic, sevoflurane. Comparisons between PTR-MS and selected ion flow tube (SIFT) investigations are presented. The second study presented in this paper investigated the volatile organic compounds emitted by microbial cell cultures. The objective was to show that different microbial cultures could be readily distinguished from the resulting mass spectra recorded using the PTR-MS. The initial results are encouraging, which taken together with the real-time analysis and high sensitivity of the PTR-MS, means that proton transfer reaction mass spectrometry has the potential to characterise bacterial infection rapidly.