[HTML][HTML] Mortality prediction in patients with severe septic shock: a pilot study using a target metabolomics approach

M Ferrario, A Cambiaghi, L Brunelli, S Giordano… - Scientific reports, 2016 - nature.com
M Ferrario, A Cambiaghi, L Brunelli, S Giordano, P Caironi, L Guatteri, F Raimondi…
Scientific reports, 2016nature.com
Septic shock remains a major problem in Intensive Care Unit, with high lethality and high-
risk second lines treatments. In this preliminary retrospective investigation we examined
plasma metabolome and clinical features in a subset of 20 patients with severe septic shock
(SOFA score> 8), enrolled in the multicenter Albumin Italian Outcome Sepsis study (ALBIOS,
NCT00707122). Our purpose was to evaluate the changes of circulating metabolites in
relation to mortality as a pilot study to be extended in a larger cohort. Patients were analyzed …
Abstract
Septic shock remains a major problem in Intensive Care Unit, with high lethality and high-risk second lines treatments. In this preliminary retrospective investigation we examined plasma metabolome and clinical features in a subset of 20 patients with severe septic shock (SOFA score >8), enrolled in the multicenter Albumin Italian Outcome Sepsis study (ALBIOS, NCT00707122). Our purpose was to evaluate the changes of circulating metabolites in relation to mortality as a pilot study to be extended in a larger cohort. Patients were analyzed according to their 28-days and 90-days mortality. Metabolites were measured using a targeted mass spectrometry-based quantitative metabolomic approach that included acylcarnitines, aminoacids, biogenic amines, glycerophospholipids, sphingolipids and sugars. Data-mining techniques were applied to evaluate the association of metabolites with mortality. Low unsaturated long-chain phosphatidylcholines and lysophosphatidylcholines species were associated with long-term survival (90-days) together with circulating kynurenine. Moreover, a decrease of these glycerophospholipids was associated to the event at 28-days and 90-days in combination with clinical variables such as cardiovascular SOFA score (28-day mortality model) or renal replacement therapy (90-day mortality model). Early changes in the plasma levels of both lipid species and kynurenine associated with mortality have potential implications for early intervention and discovering new target therapy.
nature.com