MSACL 2018 US Abstract

Topic: Various OTHER

Multiple Point-of-Care Applications of Ambient Mass Spectrometry for the Emergency Department

Jentaie Shiea (Presenter)
National Sun Yat-Sen University

Bio: Jentaie Shiea received his bachelor degree in Chemistry from National Chung-Hsing University, Taiwan in 1981. He received M.S. (1988) and Ph.D. (1991) degrees from Montana State University. His thesis studies focus on Microbial Ecology, Organic Geochemistry and Analytical/Physical Chemistry. After having a post-doctoral training at the Department of Material Science, Pennsylvania State University in 1991, he joined National Sun Yat-Sen University (NSYSU), Taiwan as a faculty member. He is now a distinguish professor of Chemistry in NSYSU. He authored or co-authored more than 200 scientific publications and presentations in internationally scientific conferences.

Authorship: Chi-Wei Lee(1), Ruei-Hao Lee (2), Yen-Ping Lin (2), Jentaie Shiea (2)
(1) Institute of Technology and Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan (2) Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan

Short Abstract

We have developed a multi-tasking ambient mass spectrometry platform which is capable of rapidly identifying pesticides in suicide patients, abused drugs in overdosed patients, and herbal toxic ingredients in intoxicated patients in the emergency department. The specimens collected from the patients include gastric lavage fluid, urine and real samples of herbal plants or herbal decoction. The turnaround time of the technique is less than one minute per sample analysis. Its limit-of-detection is at sub-ppm levels. Good reproducibility of the tests (RSD < 15%) reflects its high precision. This platform provides the information for emergency physicians to decide correct treatment in the shortest possible time.

Long Abstract

Introduction

For emergency management, it is important to promptly identify the pesticides ingested by self-poisoning patients since different pesticides cause intoxication through different mechanisms and require different therapeutic strategies. The first part of this study aims at the development of a point-of-care ambient mass spectrometric technique for rapid identification of pesticides in the drained gastric lavage fluid for emergency management. On the other hand, when multiple drugs abusers are severely overdosed and unstable, the sample pretreatment of conventional liquid chromatography-mass spectrometry for drug identification turns out to be too time-consuming. Therefore, the second part of this study aims at the development of a point-of-care ambient mass spectrometric technique for rapid identification of abused drug(s) in the urine for emergency management. In addition, Chinese herbal medicinal contain a variety of toxic ingredients, misuse often cause harmful effects on the human body. The third part of the study aims to develop an ambient mass spectrometric technique for the rapid identification of toxic ingredients in Chinese herbal medicinal in order to facilitate emergency management.

Methods

Six insecticides that are commonly ingested by self-poisoning patients in Taiwan, fiftytypes of abused drugs, and nine toxic ingredients in Chinese herbal medicinal were tested. In order to mimic the actual clinical situation, the sample solutions were prepared and diluted with human gastric juice, urine, or organic solvents respectively. A direct metallic probe was dipped and removed instantly from the sample solution. The probe was then inserted into the thermal desorption-electrospray ionization (TD-ESI) or electrospray laser desorption ionization (ELDI) source of a mass spectrometer to detect the analytes on the probe.

Results

Since no pretreatment of the specimen is required, the sampling processes following by thermal desorption or laser desorption-electrospray ionization and mass spectrometric analysis of the pesticides in the gastric juice, abused drugs in urine, and toxic herbal ingredients are completed within 60 seconds. The detection limits of the pesticides, abused drugs and toxic herbal ingredients are at sub-ppm levels

Conclusions & Discussion

It has been proved that TD-ESI (or ELDI is very promising in providing promptly toxicological information of the patients to assist succeeding medical management in an emergency room.


References & Acknowledgements:

1.Lee CW, Su H, Wu KD, Shiea J, Wu DC, Chen BH, Shin SJ. Rapid point-of-care identification of oral medications in gastric lavage content by ambient mass spectrometry in the emergency room. Rapid Commun Mass Spectrom. 2016 Jun 15;30(11):1295-303.

2.Lee CW, Su H, Chen PY, Lin SJ, Shiea J, Shin SJ, Chen BH. Rapid identification of pesticides in human oral fluid for emergency management by thermal desorption electrospray ionization/mass spectrometry. J Mass Spectrom. 2016 Feb;51(2):97-104.

3.Lee CW, Su H, Cai YD, Wu MT, Wu DC, Shiea J. Rapid Identification of Psychoactive Drugs in Drained Gastric Lavage Fluid and Whole Blood Specimens of Drug Overdose Patients Using Ambient Mass Spectrometry. Mass Spectrom (Tokyo). 2017;6(2):S0056.


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