Metabolic Profiling in Patients with Pneumonia on Intensive Care
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 met...
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doaj-bc6339dd5ec44e45bee71722ba1b9d012020-11-25T02:11:38ZengElsevierEBioMedicine2352-39642017-04-0118C24425310.1016/j.ebiom.2017.03.034Metabolic Profiling in Patients with Pneumonia on Intensive CareDavid Antcliffe0Beatriz Jiménez1Kirill Veselkov2Elaine Holmes3Anthony C. Gordon4Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UKDivision of Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UKDivision of Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UKDivision of Computational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UKSection of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UKClinical 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.http://www.sciencedirect.com/science/article/pii/S2352396417301305MetabonomicsPneumoniaVentilatior associated pneumonia (VAP)Intensive careBrain injuryVentilation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David Antcliffe Beatriz Jiménez Kirill Veselkov Elaine Holmes Anthony C. Gordon |
spellingShingle |
David Antcliffe Beatriz Jiménez Kirill Veselkov Elaine Holmes Anthony C. Gordon Metabolic Profiling in Patients with Pneumonia on Intensive Care EBioMedicine Metabonomics Pneumonia Ventilatior associated pneumonia (VAP) Intensive care Brain injury Ventilation |
author_facet |
David Antcliffe Beatriz Jiménez Kirill Veselkov Elaine Holmes Anthony C. Gordon |
author_sort |
David Antcliffe |
title |
Metabolic Profiling in Patients with Pneumonia on Intensive Care |
title_short |
Metabolic Profiling in Patients with Pneumonia on Intensive Care |
title_full |
Metabolic Profiling in Patients with Pneumonia on Intensive Care |
title_fullStr |
Metabolic Profiling in Patients with Pneumonia on Intensive Care |
title_full_unstemmed |
Metabolic Profiling in Patients with Pneumonia on Intensive Care |
title_sort |
metabolic profiling in patients with pneumonia on intensive care |
publisher |
Elsevier |
series |
EBioMedicine |
issn |
2352-3964 |
publishDate |
2017-04-01 |
description |
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. |
topic |
Metabonomics Pneumonia Ventilatior associated pneumonia (VAP) Intensive care Brain injury Ventilation |
url |
http://www.sciencedirect.com/science/article/pii/S2352396417301305 |
work_keys_str_mv |
AT davidantcliffe metabolicprofilinginpatientswithpneumoniaonintensivecare AT beatrizjimenez metabolicprofilinginpatientswithpneumoniaonintensivecare AT kirillveselkov metabolicprofilinginpatientswithpneumoniaonintensivecare AT elaineholmes metabolicprofilinginpatientswithpneumoniaonintensivecare AT anthonycgordon metabolicprofilinginpatientswithpneumoniaonintensivecare |
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