Prognosis Biomarkers of Severe Sepsis and Septic Shock by 1H NMR Urine Metabolomics in the Intensive Care Unit.
نویسندگان
چکیده
Early diagnosis and patient stratification may improve sepsis outcome by a timely start of the proper specific treatment. We aimed to identify metabolomic biomarkers of sepsis in urine by (1)H-NMR spectroscopy to assess the severity and to predict outcomes. Urine samples were collected from 64 patients with severe sepsis or septic shock in the ICU for a (1)H NMR spectra acquisition. A supervised analysis was performed on the processed spectra, and a predictive model for prognosis (30-days mortality/survival) of sepsis was constructed using partial least-squares discriminant analysis (PLS-DA). In addition, we compared the prediction power of metabolomics data respect the Sequential Organ Failure Assessment (SOFA) score. Supervised multivariate analysis afforded a good predictive model to distinguish the patient groups and detect specific metabolic patterns. Negative prognosis patients presented higher values of ethanol, glucose and hippurate, and on the contrary, lower levels of methionine, glutamine, arginine and phenylalanine. These metabolites could be part of a composite biopattern of the human metabolic response to sepsis shock and its mortality in ICU patients. The internal cross-validation showed robustness of the metabolic predictive model obtained and a better predictive ability in comparison with SOFA values. Our results indicate that NMR metabolic profiling might be helpful for determining the metabolomic phenotype of worst-prognosis septic patients in an early stage. A predictive model for the evolution of septic patients using these metabolites was able to classify cases with more sensitivity and specificity than the well-established organ dysfunction score SOFA.
منابع مشابه
بررسی موارد سپسیس و شوک سپتیک در بخش مراقبت های ویژه بیمارستان مرکز طبی کودکان
Sepsis is the systemic response to severe infection in critically ill patients. Sepsis, septic syndrome & septic shock represent the increasingly severe stages of the same disease. Despite the remarkable improvements in outcome, sepsis & septic shock remain an important cause of morbidity & mortality in children. This is a retrospective study among the patients who were admitted in the pediatri...
متن کاملMetabolomics in critical care medicine: a new approach to biomarker discovery.
PURPOSE To present an overview and comparison of the main metabolomics techniques (1H NMR, GC-MS, and LC-MS) and their current and potential use in critical care medicine. SOURCE This is a focused review, not a systematic review, using the PubMed database as the predominant source of references to compare metabolomics techniques. PRINCIPAL FINDINGS 1H NMR, GC-MS, and LC-MS are complementary...
متن کاملMetabolomics approach reveals urine biomarkers and pathways associated with the pathogenesis of lupus nephritis
Objective(s): lupus nephritis (LN) is a severe form of systemic lupus erythematosus (SLE) with renal complications. Current diagnosis is based on invasive renal biopsy and serum antibodies and complement levels that are not specific enough. The current study aims to identify new biomarker candidates for non-invasive diagnosis of LN and explore the pathogenic mechanisms...
متن کاملAssociation of the immature platelet fraction with sepsis diagnosis and severity
Management of Sepsis would greatly benefit from the incorporation of simple and informative new biomarkers in clinical practice. Ideally, a sepsis biomarker should segregate infected from non-infected patients, provide information about prognosis and organ-specific damage, and be accessible to most healthcare services. The immature platelet fraction (IPF) and immature reticulocyte fraction (IRF...
متن کاملOptimal Aminoglycoside Therapy Following the Sepsis: How Much Is Too Much?
Severe sepsis and septic shock are major problems as the result of high rates morbidity andmortality in intensive care units (ICUs). In the presence of septic shock, each hour of delay inthe administration of effective antibiotics is associated with a measurable increase in mortality.Aminoglycosides are effective broad-spectrum antibiotics that are commonly used in ICUs forthe treatment of life...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- PloS one
دوره 10 11 شماره
صفحات -
تاریخ انتشار 2015