title: Metabotyping Patients' Journeys Reveals Early Predisposition to Lung Injury after Cardiac Surgery.
abstract: Cardiovascular disease is the leading cause of death worldwide and patients with severe symptoms undergo cardiac surgery. Even after uncomplicated surgeries, some patients experience postoperative complications such as lung injury. We hypothesized that the procedure elicits metabolic activity that can be related to the disease progression, which is commonly observed two-three days postoperatively. More than 700 blood samples were collected from 50 patients at nine time points pre-, intra-, and postoperatively. Dramatic metabolite shifts were observed during and immediately after the intervention. Prolonged surgical stress was linked to an augmented anaerobic environment. Time series analysis showed shifts in purine-, nicotinic acid-, tyrosine-, hyaluronic acid-, ketone-, fatty acid, and lipid metabolism. A characteristic 'metabolic biosignature' was identified correlating with the risk of developing postoperative complications two days before the first clinical signs of lung injury. Hence, this study demonstrates the link between intra- and postoperative time-dependent metabolite changes and later postoperative outcome. In addition, the results indicate that metabotyping patients' journeys early, during or just after the end of surgery, may have potential impact in hospitals for the early diagnosis of postoperative lung injury, and for the monitoring of therapeutics targeting disease progression.
authors.affiliation: Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Denmark.|Department of Chemistry and Bioscience, Aalborg University, Denmark.|Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Raluca Georgiana
authors.initials: RG
authors.lastname: Maltesen
authors.affiliation: Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Denmark.|Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Bodil Steen
authors.initials: BS
authors.lastname: Rasmussen
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark.|Department of Clinical Biochemistry, Aalborg University Hospital, Denmark.
authors.forename: Shona
authors.initials: S
authors.lastname: Pedersen
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark.
authors.forename: Munsoor Ali
authors.initials: MA
authors.lastname: Hanifa
authors.affiliation: Department of Chemistry and Bioscience, Aalborg University, Denmark.
authors.forename: Sergey
authors.initials: S
authors.lastname: Kucheryavskiy
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark.|Department of Clinical Biochemistry, Aalborg University Hospital, Denmark.
authors.forename: Søren Risom
authors.initials: SR
authors.lastname: Kristensen
authors.affiliation: Department of Chemistry and Bioscience, Aalborg University, Denmark.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Wimmer
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000378:metabolism*; D011184:Postoperative Period; D013312:Stress, Physiological