(From left to right) Mike Davis, Alison Montpetit, Curt Sessler, Paul Dalby, Michelle Jump and Lois Rowland display how the ALFA equipment connects to a ventilator.
Imagine being able to detect lung infections by just breathing into a device. Alison Montpetit, Ph.D., RN, assistant professor at the VCU School of Nursing, is leading an exhaled breath study that may one day lead to the design of a point-of-care or at-home test.
Montpetit is the principal investigator of an interdisciplinary team awarded a K99/R00 Pathways to Independence grant from the National Institute of Nursing Research of the National Institutes of Health. The $882,000 grant funds a five-year study, titled “Exhaled Biomarkers of Pulmonary Infection in the Critically Ill,” that focuses on examining breath, blood and sputum of mechanically ventilated, critically ill patients for early signs of pulmonary infection.
The study involves working with patients in the Intensive Care Unit at VCU Medical Center using an Airway Lining Fluid Analyzer (ALFA). Connected through a ventilator, the ALFA collects, cools and condenses the patient’s breath into water or exhaled breath condensate (EBC).
“In our study, we continuously monitor EBC pH, look for a panel of immune markers in EBC samples and analyze relationships between those biomarkers and a score of pulmonary infection.” Montpetit said. “If we can identify those early biomarkers, we can develop a breath test to monitor for lung infection. By knowing an infectious process is developing, we can treat it earlier and subsequently prevent lung disease exacerbations and damage. This could have broad implications for patients in the hospital and at home.”
A study of this scope requires collaboration with various clinicians and researchers in several health sciences at VCU and beyond. Montpetit’s interdisciplinary team includes R.K. Elswick, Ph.D., co-investigator, biostatistician and professor of Nursing, Curt Sessler, M.D., co-investigator, the Orhan Muren Distinguished Professor and director of the Center for Adult Critical Care, VCU School of Medicine Mike Davis, B.S., RRT, project director and respiratory therapist; and Michelle Jump, a junior nursing student and research assistant. Because this study focuses on the mechanically ventilated population, one significant relationship is the partnership and support from the VCUHS Department of Respiratory Therapy specifically, Paul Dalby M.B.A., RRT, FACHE, VCUHS director of Respiratory Care and Pulmonary Function, and Lois Rowland, M.S., RRT, respiratory therapy education coordinator at VCUHS.
Jump, who gathers and organizes pertinent patient data and collects exhaled breath specimens, said she is proud to be a part of the team of clinicians and researchers.
“I work with amazing people who are passionate about elevating medical science through the integration of basic science with clinical care,” said Jump, who aspires to become an intensive care RN. “There are not many institutions that are as adept at translational research as VCU, and Dr. Montpetit definitely heightens the university, as well as the School of Nursing, with her unique experience and skill sets.”
The team also consults with John Hunt, M.D., associate professor in the Pediatric Respiratory Medicine & Allergy Division of UVA’s School of Medicine. According to Montpetit, VCU and UVA are the first two sites in the nation to employ ALFA technology, which was developed by the U.S. Air Force and Respiratory Research, Inc., a UVA-faculty owned company.
Launched in April 2012, the R00 phase of the study currently has 18 of the 75 desired participants. The results hold promise for non-invasive early disease detection.
“We hope our findings will move us closer to the development of breath tests for detecting infection and improving health outcomes for patients suffering from lung disease” Montpetit said.
The clinical significance of Montpetit’s exhaled breath research has not gone unnoticed in the nursing field. The R00 grant from National Institute of Nursing Research is the second she has received since coming to VCU, demonstrating her research’s increasing value to nursing. In 2010, Montpetit was the School of Nursing’s first postdoctoral fellow to receive the K99 grant, which was co-sponsored by Mary Jo Grap, Ph.D., R.N., FAAN, Nursing Alumni Distinguished Professor and interim associate dean of research. Grap has also worked with an interdisciplinary research team at VCU on the same topic for more than 15 years.
Having served as her mentor, Grap said she is proud to see Montpetit making an impact as a rising nurse scientist.
“Dr. Montpetit's program of research is incredibly innovative and solidly based on her exquisite background in the basic sciences,” Grap said. “She is uniquely qualified to make considerable contributions to early, point of care testing that will provide important information for early diagnosis and treatment.”