Limits...
Integration of metabolic and inflammatory mediator profiles as a potential prognostic approach for septic shock in the intensive care unit.

Mickiewicz B, Tam P, Jenne CN, Leger C, Wong J, Winston BW, Doig C, Kubes P, Vogel HJ, Alberta Sepsis Netwo - Crit Care (2015)

Bottom Line: Therefore, the identification of new diagnostic tools remains a priority for increasing the survival rate of ICU patients.The analysis of the inflammatory mediators was performed using human cytokine and chemokine assay kits.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.

View Article: PubMed Central - PubMed

Affiliation: Bio-NMR-Centre, Department of Biological Sciences, University of Calgary, 2500 University Drive Northwest, Calgary, AB, T2N 1N4, Canada. bmmickie@ucalgary.ca.

ABSTRACT

Introduction: 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.

No MeSH data available.


Related in: MedlinePlus

The receiver operating characteristic (ROC) curve plots. The ROC plots for (A) septic shock patients vs. intensive care unit (ICU) controls and (B) septic shock nonsurvivors vs. septic shock survivors models based on the metabolomics data, cytokine/chemokine data and the combined dataset (metabolites together with inflammatory mediators), acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores. Black line - fit line, grey line - empirical data, red dashed line - the chance curve. To further show the details of these curves in the range of false positive fraction the Additional file 5 shows the ROC curves redrawn with a decimal logarithm scale for the horizontal axes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4340832&req=5

Fig4: The receiver operating characteristic (ROC) curve plots. The ROC plots for (A) septic shock patients vs. intensive care unit (ICU) controls and (B) septic shock nonsurvivors vs. septic shock survivors models based on the metabolomics data, cytokine/chemokine data and the combined dataset (metabolites together with inflammatory mediators), acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores. Black line - fit line, grey line - empirical data, red dashed line - the chance curve. To further show the details of these curves in the range of false positive fraction the Additional file 5 shows the ROC curves redrawn with a decimal logarithm scale for the horizontal axes.

Mentions: Comparison of statistical measures for septic shock patients vs. ICU controls and septic shock nonsurvivors vs. septic shock survivors models based on metabolomics data, cytokine/chemokine data, combined dataset (metabolites together with inflammatory mediators), acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores. The receiver operating characteristic (ROC) curve plots for each dataset are shown in Figure 4. α, false positive rate; β, false negative rate; PPV, positive predictive value; NPV, negative predictive value; ACC, accuracy; AUROC, area under the receiver operating characteristic curve (value ± standard error as calculated from the ROC curves); ICU, intensive care unit.


Integration of metabolic and inflammatory mediator profiles as a potential prognostic approach for septic shock in the intensive care unit.

Mickiewicz B, Tam P, Jenne CN, Leger C, Wong J, Winston BW, Doig C, Kubes P, Vogel HJ, Alberta Sepsis Netwo - Crit Care (2015)

The receiver operating characteristic (ROC) curve plots. The ROC plots for (A) septic shock patients vs. intensive care unit (ICU) controls and (B) septic shock nonsurvivors vs. septic shock survivors models based on the metabolomics data, cytokine/chemokine data and the combined dataset (metabolites together with inflammatory mediators), acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores. Black line - fit line, grey line - empirical data, red dashed line - the chance curve. To further show the details of these curves in the range of false positive fraction the Additional file 5 shows the ROC curves redrawn with a decimal logarithm scale for the horizontal axes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4340832&req=5

Fig4: The receiver operating characteristic (ROC) curve plots. The ROC plots for (A) septic shock patients vs. intensive care unit (ICU) controls and (B) septic shock nonsurvivors vs. septic shock survivors models based on the metabolomics data, cytokine/chemokine data and the combined dataset (metabolites together with inflammatory mediators), acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores. Black line - fit line, grey line - empirical data, red dashed line - the chance curve. To further show the details of these curves in the range of false positive fraction the Additional file 5 shows the ROC curves redrawn with a decimal logarithm scale for the horizontal axes.
Mentions: Comparison of statistical measures for septic shock patients vs. ICU controls and septic shock nonsurvivors vs. septic shock survivors models based on metabolomics data, cytokine/chemokine data, combined dataset (metabolites together with inflammatory mediators), acute physiology and chronic health evaluation (APACHE) and sequential organ failure assessment (SOFA) scores. The receiver operating characteristic (ROC) curve plots for each dataset are shown in Figure 4. α, false positive rate; β, false negative rate; PPV, positive predictive value; NPV, negative predictive value; ACC, accuracy; AUROC, area under the receiver operating characteristic curve (value ± standard error as calculated from the ROC curves); ICU, intensive care unit.

Bottom Line: Therefore, the identification of new diagnostic tools remains a priority for increasing the survival rate of ICU patients.The analysis of the inflammatory mediators was performed using human cytokine and chemokine assay kits.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.

View Article: PubMed Central - PubMed

Affiliation: Bio-NMR-Centre, Department of Biological Sciences, University of Calgary, 2500 University Drive Northwest, Calgary, AB, T2N 1N4, Canada. bmmickie@ucalgary.ca.

ABSTRACT

Introduction: 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.

No MeSH data available.


Related in: MedlinePlus