Z. Yin, W. Xiong, K. Zhang, X. Luo, M. Wei, K.D. Singh1,2, U. Frey, X. Li, X. Feng, and P. Sinues

Breath metabolomics under lidocaine-SGB
This pilot study provides the first real-time metabolic profiling of lidocaine-based stellate ganglion block (SGB) using high-resolution breath analysis (SESI-HRMS). In 28 participants, more than 300 metabolites were significantly altered after lidocaine injection, including both drug-derived compounds and endogenous metabolites linked to fatty-acid oxidation and amino-acid metabolism. The findings demonstrate that breath metabolomics can simultaneously capture drug metabolism and host physiological responses, while revealing notable inter-individual variability. This work positions breath-based pharmacometabolomics as a promising tool for personalized monitoring and optimization of SGB interventions in clinical practice.

J. Zeng, N. Stankovic, K. D. Singh, R. Steiner, U. Frey, T. Erb, P. Sinues

Breath Pharmacometabolomics of Propofol Anesthesia in Children
This pilot study demonstrates that on-site SESI-HRMS breath analysis can robustly track propofol and its metabolites in pediatric patients, with exhaled signals showing strong correlation to serum concentrations (R² ≥ 0.65). Beyond pharmacokinetics, SESI revealed surgery-induced metabolic responses, including elevated fatty aldehydes—markers of oxidative stress and lipid peroxidation. Conducted in children undergoing IV anesthesia, this work highlights real-time, non-invasive breath profiling as a promising tool for individualized anesthetic monitoring and metabolic assessment during surgery.

Jiafa Zeng, Jakob Usemann, Kapil Dev Singh, Anja Jochmann, Daniel Trachsel, Urs Frey, Pablo Sinues

Pharmacometabolomics via exhaled breath analysis holds promise for patient stratification. Here, we integrate a real-time breath analysis platform in the workflow of an outpatient clinic to provide a detailed metabolic snapshot of patients with asthma undergoing standard clinical evaluations. We observed significant metabolic changes associated with salbutamol inhalation within ∼1 h. Our data supports the hypothesis that sphingolipid metabolism and arginine biosynthesis mediate the bronchodilator effect of salbutamol…

F. Schmidt ; M. Osswald ; R. Zenobi ; M. Kohler

Monitoring of drug pharmacokinetics is used in personalized therapy, therapeutic drug monitoring (TDM), toxicology assessments, doping controls and clinical drug development. Drugs are predominantly measured in plasma, serum or urine. Monitoring of volatile organic compounds (VOCs) in breath has so far not received much attention, but nevertheless it has many advantages over conventional approaches