Integration of metabolic and inflammatory mediator profiles as a potential prognostic approach for septic shock in the intensive care unit.
BACKGROUND
Septic shock is a major life-threatening condition in critically ill patients and it is well known that early recognition of septic shock and expedient initiation of appropriate treatment improves patient outcome. Unfortunately, to date no single compound has shown sufficient sensitivity and specificity to be used as a routine biomarker for early diagnosis and prognosis of septic shock in the intensive care unit (ICU). Therefore, the identification of new diagnostic tools remains a priority for increasing the survival rate of ICU patients. In this study, we have evaluated whether a combined nuclear magnetic resonance spectroscopy-based metabolomics and a multiplex cytokine/chemokine profiling approach could be used for diagnosis and prognostic evaluation of septic shock patients in the ICU.


METHODS
Serum and plasma samples were collected from septic shock patients and ICU controls (ICU patients with the systemic inflammatory response syndrome but not suspected of having an infection). (1)H Nuclear magnetic resonance spectra were analyzed and quantified using the targeted profiling methodology. The analysis of the inflammatory mediators was performed using human cytokine and chemokine assay kits.


RESULTS
By using multivariate statistical analysis we were able to distinguish patient groups and detect specific metabolic and cytokine/chemokine patterns associated with septic shock and its mortality. These metabolites and cytokines/chemokines represent candidate biomarkers of the human response to septic shock and have the potential to improve early diagnosis and prognosis of septic shock.


CONCLUSIONS
Our findings show that integration of quantitative metabolic and inflammatory mediator data can be utilized for the diagnosis and prognosis of septic shock in the ICU.
Bio-NMR-Centre, Department of Biological Sciences, University of Calgary, 2500 University Drive Northwest, Calgary, AB, T2N 1N4, Canada. bmmickie@ucalgary.ca.
Beata
B
Mickiewicz
Snyder Translational Laboratory, Department of Critical Care Medicine, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. tam.patrickpc@gmail.com.
Patrick
P
Tam
Snyder Translational Laboratory, Department of Critical Care Medicine, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. cnjenne@ucalgary.ca.
Craig N
CN
Jenne
Snyder Translational Laboratory, Department of Critical Care Medicine, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. legercaroline@yahoo.ca.
Caroline
C
Leger
Critical Care Epidemiologic and Biologic Tissue Resource, Department of Critical Care Medicine, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. jfwong@ucalgary.ca.
Josee
J
Wong
Critical Care Epidemiologic and Biologic Tissue Resource, Department of Critical Care Medicine, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. bwinston@ucalgary.ca.
Brent W
BW
Winston
Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. cdoig@ucalgary.ca.
Christopher
C
Doig
Snyder Institute for Chronic Diseases, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. pkubes@ucalgary.ca.
Paul
P
Kubes
Bio-NMR-Centre, Department of Biological Sciences, University of Calgary, 2500 University Drive Northwest, Calgary, AB, T2N 1N4, Canada. vogel@ucalgary.ca.
Hans J
HJ
Vogel
D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007362:Intensive Care Units; D008297:Male; D055442:Metabolome / Q000502:physiology*; D008875:Middle Aged; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis*
D015415:Biomarkers; D018836:Inflammation Mediators