A prospective pilot study using metabolomics discloses specific fatty acid, catecholamine and tryptophan metabolic pathways as possible predictors for a negative outcome after severe trauma

Background We wanted to define metabolomic patterns in plasma to predict a negative outcome in severe trauma patients. Methods A prospective pilot study was designed to evaluate plasma metabolomic patterns, established by liquid chromatography coupled to mass spectrometry, in patients allocated to a...

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Published in:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Resuscitation and Emergency Medicine, 2019, Vol.27 (1)
Main Authors: Servia, Luis, Jove, Mariona, Sol, Joaquim, Pamplona, Reinald, Badia, Mariona, Montserrat, Neus, Portero-Otin, Manuel, Trujillano, Javier
Format: Report
Language:English
Subjects:
Adrenergic agonists
Amino acids
Brain injuries
Chromatography
Epinephrine
Fatty acid metabolism
Fatty acids
Glucocorticoids
Health aspects
Liquid chromatography
Mass spectrometry
Medical research
Metabolites
Mortality
Patient outcomes
Saturated fatty acids
Spectroscopy
Tryptophan
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Summary:Background We wanted to define metabolomic patterns in plasma to predict a negative outcome in severe trauma patients. Methods A prospective pilot study was designed to evaluate plasma metabolomic patterns, established by liquid chromatography coupled to mass spectrometry, in patients allocated to an intensive care unit (in the University Hospital Arnau de Vilanova, Lleida, Spain) in the first hours after a severe trauma (n = 48). Univariate and multivariate statistics were employed to establish potential predictors of mortality. Results Plasma of patients non surviving to trauma (n = 5) exhibited a discriminating metabolomic pattern, involving basically metabolites belonging to fatty acid and catecholamine synthesis as well as tryptophan degradation pathways. Thus, concentration of several metabolites exhibited an area under the receiver operating curve (ROC) higher than 0.84, including 3-indolelactic acid, hydroxyisovaleric acid, phenylethanolamine, cortisol, epinephrine and myristic acid. Multivariate binary regression logistic revealed that patients with higher myristic acid concentrations had a non-survival odds ratio of 2.1 (CI 95% 1.1-3.9). Conclusions Specific fatty acids, catecholamine synthesis and tryptophan degradation pathways could be implicated in a negative outcome after trauma. The metabolomic study of severe trauma patients could be helpful for biomarker proposal. Keywords: Metabolome, Mortality, Traumatic brain injury, Biomarker, Multiple traumatism
ISSN:1757-7241
1757-7241
DOI:10.1186/s13049-019-0631-5