دورية أكاديمية
أعرض في EDS

Plasma Metabolites in Early Sepsis Identify Distinct Clusters Defined by Plasma Lipids.

التفاصيل البيبلوغرافية
العنوان: Plasma Metabolites in Early Sepsis Identify Distinct Clusters Defined by Plasma Lipids.
المؤلفون: Rogers AJ; Division of Pulmonary and Critical Care, Department of Medicine, Stanford, CA., Leligdowicz A; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA.; Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada., Contrepois K; Department of Genetics, Stanford University School of Medicine, Stanford, CA., Jauregui A; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Vessel K; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Deiss TJ; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Belzer A; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Liu T; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Lippi M; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Ke S; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Ross E; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Zhou H; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Hendrickson C; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Gomez A; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Sinha P; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Kangelaris KN; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Liu KD; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Calfee CS; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA., Matthay MA; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA.
المصدر: Critical care explorations [Crit Care Explor] 2021 Jul 29; Vol. 3 (8), pp. e0478. Date of Electronic Publication: 2021 Jul 29 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]-
مستخلص: Unbiased global metabolomic profiling has not been used to identify distinct subclasses in patients with early sepsis and sepsis-associated acute respiratory distress syndrome. In this study, we examined whether the plasma metabolome reflects systemic illness in early sepsis and in acute respiratory distress syndrome.
Design: Plasma metabolites were measured in subjects with early sepsis.
Setting: Patients were admitted from the emergency department to the ICU in a plasma sample collected within 24 hours of ICU admission. Metabolic profiling of 970 metabolites was performed by Metabolon (Durham, NC). Hierarchical clustering and partial least squares discriminant clustering were used to identify distinct clusters among patients with early sepsis and sepsis-associated acute respiratory distress syndrome.
Interventions: None.
Measurements and Main Results: Among critically ill patients with early sepsis ( n = 197), three metabolically distinct subgroups were identified, with metabolic subtype driven by plasma lipids. Group 1, with 45 subjects (23% of cohort), had increased 60-day mortality (odds ratio, 2; 95% CI, 0.99-4.0; p = 0.04 for group 1 vs all others). This group also had higher rates of vasopressor-dependent shock, acute kidney injury, and met Berlin acute respiratory distress syndrome criteria more often (all p < 0.05). Conversely, metabolic group 3, with 76 subjects (39% of cohort), had the lowest risk of 60-day mortality (odds ratio, 0.44; 95% CI, 0.22-0.86; p = 0.01) and lower rates of organ dysfunction as reflected in a lower Simplified Acute Physiology Score II ( p < 0.001). In contrast, global metabolomic profiling did not separate patient with early sepsis with moderate-to-severe acute respiratory distress syndrome ( n = 78) from those with sepsis without acute respiratory distress syndrome ( n = 75).
Conclusions: Plasma metabolomic profiling in patients with early sepsis identified three metabolically distinct groups that were characterized by different plasma lipid profiles, distinct clinical phenotypes, and 60-day mortality. Plasma metabolites did not distinguish patients with early sepsis who developed acute respiratory distress syndrome from those who did not.
(Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
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معلومات مُعتمدة: R01 HL152083 United States HL NHLBI NIH HHS; R35 HL140026 United States HL NHLBI NIH HHS; K23 HL125663 United States HL NHLBI NIH HHS; R01 HL051856 United States HL NHLBI NIH HHS; R37 HL051856 United States HL NHLBI NIH HHS; K23 HL116800 United States HL NHLBI NIH HHS
فهرسة مساهمة: Keywords: acute respiratory distress syndrome; clustering; metabolomics; phenotype; sepsis
تواريخ الأحداث: Date Created: 20210804 Latest Revision: 20210828
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8323800
DOI: 10.1097/CCE.0000000000000478
PMID: 34345827
قاعدة البيانات: MEDLINE
الوصف
تدمد:2639-8028
DOI:10.1097/CCE.0000000000000478