Clinica chimica acta; international journal of clinical chemistry · 2018
Point-of-care identification of organophosphates in gastric juice by ambient mass spectrometry in emergency settings.
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Lee Chi-Wei, Su Hung, Lee Ruei-Hao, Lin Yen-Ping, Tsai You-Da, Wu Deng-Chyang, Shiea Jentaie
Аннотация
BACKGROUND: For emergency management, it is important to promptly identify the organophosphate ingested by self-poisoning patients since different organophosphates cause intoxication through different mechanisms and require different therapeutic strategies. This study aimed at the development of a point-of-care ambient mass spectrometric approach for rapid identification of organophosphate(s) in gastric juice for emergency management.
METHODS: Six organophosphate insecticides that are commonly ingested by self-poisoning patients in Taiwan were examined. The sample solutions were prepared and diluted with human gastric juice. A direct metallic probe was dipped and removed immediately from the sample solution. The probe was then inserted into the thermal desorption-electrospray ionization/mass spectrometry (TD-ESI/MS) to detect the analyte on the probe.
RESULTS: Since no pretreatment of the specimen was required, the sampling processes followed by thermal desorption-electrospray ionization and mass spectrometric analysis of the organophosphate in the gastric juice were completed within 30 s. The detection limit of the organophosphates is at the 10-100 parts per billion level. Good linearity was observed between the corresponding changes in mass spectrometric signal intensities and the changes of organophosphate concentrations within the range of 5-1000 parts per billion. The high efficiency of this ambient mass spectrometric platform was further confirmed when a real sample of the drained gastric lavage fluid of a patient who suffered from ingestion of chlorpyrifos was collected in the emergency room and tested with this cutting-edge technique.
CONCLUSIONS: The results suggested that TD-ESI/MS is promising in promptly providing toxicological information to assist succeeding medical management in an emergency room.
METHODS: Six organophosphate insecticides that are commonly ingested by self-poisoning patients in Taiwan were examined. The sample solutions were prepared and diluted with human gastric juice. A direct metallic probe was dipped and removed immediately from the sample solution. The probe was then inserted into the thermal desorption-electrospray ionization/mass spectrometry (TD-ESI/MS) to detect the analyte on the probe.
RESULTS: Since no pretreatment of the specimen was required, the sampling processes followed by thermal desorption-electrospray ionization and mass spectrometric analysis of the organophosphate in the gastric juice were completed within 30 s. The detection limit of the organophosphates is at the 10-100 parts per billion level. Good linearity was observed between the corresponding changes in mass spectrometric signal intensities and the changes of organophosphate concentrations within the range of 5-1000 parts per billion. The high efficiency of this ambient mass spectrometric platform was further confirmed when a real sample of the drained gastric lavage fluid of a patient who suffered from ingestion of chlorpyrifos was collected in the emergency room and tested with this cutting-edge technique.
CONCLUSIONS: The results suggested that TD-ESI/MS is promising in promptly providing toxicological information to assist succeeding medical management in an emergency room.