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Metabolic profiling in patients with pneumonia on intensive care

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Title: Metabolic profiling in patients with pneumonia on intensive care
Authors: Antcliffe, D
Jimenez, B
Veselkov, K
Holmes, E
Gordon, AC
Item Type: Journal Article
Abstract: Clinical features and investigations lack predictive value when diagnosing pneumonia, especially when patients are ventilated and when patients develop ventilator associated pneumonia (VAP). New tools to aid diagnosis are important to improve outcomes. This pilot study examines the potential for metabolic profiling to aid the diagnosis in critical care. In this prospective observational study ventilated patients with brain injuries or pneumonia were recruited in the intensive care unit and serum samples were collected soon after the start of ventilation. Metabolic profiles were produced using 1D 1H NMR spectra. Metabolic data were compared using multivariate statistical techniques including Principal Component Analysis (PCA) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA). We recruited 15 patients with pneumonia and 26 with brain injuries, seven of whom went on to develop VAP. Comparison of metabolic profiles using OPLS-DA differentiated those with pneumonia from those with brain injuries (R2Y = 0.91, Q2Y = 0.28, p = 0.02) and those with VAP from those without (R2Y = 0.94, Q2Y = 0.27, p = 0.05). Metabolites that differentiated patients with pneumonia included lipid species, amino acids and glycoproteins. Metabolic profiling shows promise to aid in the diagnosis of pneumonia in ventilated patients and may allow a more timely diagnosis and better use of antibiotics.
Issue Date: 29-Mar-2017
Date of Acceptance: 24-Mar-2017
URI: http://hdl.handle.net/10044/1/45041
DOI: https://dx.doi.org/10.1016/j.ebiom.2017.03.034
ISSN: 2352-3964
Publisher: Elsevier
Start Page: 244
End Page: 253
Journal / Book Title: EBioMedicine
Volume: 18
Copyright Statement: © 2017 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Sponsor/Funder: The Intensive Care Foundation
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: N/A
RDB03 79560
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
Metabonomics
Pneumonia
Ventilatior associated pneumonia (VAP)
Intensive care
Brain injury
Ventilation
VENTILATOR-ASSOCIATED PNEUMONIA
BRONCHOALVEOLAR LAVAGE FLUID
SERUM PHENYLALANINE
NMR-SPECTROSCOPY
SEPTIC SHOCK
SEPSIS
DIAGNOSIS
CORRELATE
INFECTION
BIOMARKER
Publication Status: Published
Open Access location: http://www.ebiomedicine.com/article/S2352-3964(17)30130-5/abstract
Appears in Collections:Division of Surgery
Faculty of Medicine



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