Mortality prediction in patients with severe septic shock

A pilot study using a target metabolomics approach

Manuela Ferrario, Alice Cambiaghi, Laura Brunelli, Silvia Giordano, Pietro Caironi, Luca Guatteri, Ferdinando Raimondi, Luciano Gattinoni, Roberto Latini, Serge Masson, Giuseppe Ristagno, Roberta Pastorelli

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Septic shock remains a major problem in Intensive Care Unit, with high lethality and high-risk second lines treatments. In this preliminary retrospective investigation we examined plasma metabolome and clinical features in a subset of 20 patients with severe septic shock (SOFA score >8), enrolled in the multicenter Albumin Italian Outcome Sepsis study (ALBIOS, NCT00707122). Our purpose was to evaluate the changes of circulating metabolites in relation to mortality as a pilot study to be extended in a larger cohort. Patients were analyzed according to their 28-days and 90-days mortality. Metabolites were measured using a targeted mass spectrometry-based quantitative metabolomic approach that included acylcarnitines, aminoacids, biogenic amines, glycerophospholipids, sphingolipids, and sugars. Data-mining techniques were applied to evaluate the association of metabolites with mortality. Low unsaturated long-chain phosphatidylcholines and lysophosphatidylcholines species were associated with long-term survival (90-days) together with circulating kynurenine. Moreover, a decrease of these glycerophospholipids was associated to the event at 28-days and 90-days in combination with clinical variables such as cardiovascular SOFA score (28-day mortality model) or renal replacement therapy (90-day mortality model). Early changes in the plasma levels of both lipid species and kynurenine associated with mortality have potential implications for early intervention and discovering new target therapy.

Original languageEnglish
Article number20391
JournalScientific Reports
Volume6
DOIs
Publication statusPublished - Feb 5 2016

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Metabolomics
Septic Shock
Mortality
Glycerophospholipids
Kynurenine
Lysophosphatidylcholines
Sphingolipids
Biogenic Amines
Data Mining
Renal Replacement Therapy
Metabolome
Phosphatidylcholines
Intensive Care Units
Albumins
Mass Spectrometry
Sepsis
Outcome Assessment (Health Care)
Lipids
Survival
Therapeutics

ASJC Scopus subject areas

  • General

Cite this

Mortality prediction in patients with severe septic shock : A pilot study using a target metabolomics approach. / Ferrario, Manuela; Cambiaghi, Alice; Brunelli, Laura; Giordano, Silvia; Caironi, Pietro; Guatteri, Luca; Raimondi, Ferdinando; Gattinoni, Luciano; Latini, Roberto; Masson, Serge; Ristagno, Giuseppe; Pastorelli, Roberta.

In: Scientific Reports, Vol. 6, 20391, 05.02.2016.

Research output: Contribution to journalArticle

Ferrario, M, Cambiaghi, A, Brunelli, L, Giordano, S, Caironi, P, Guatteri, L, Raimondi, F, Gattinoni, L, Latini, R, Masson, S, Ristagno, G & Pastorelli, R 2016, 'Mortality prediction in patients with severe septic shock: A pilot study using a target metabolomics approach', Scientific Reports, vol. 6, 20391. https://doi.org/10.1038/srep20391
Ferrario, Manuela ; Cambiaghi, Alice ; Brunelli, Laura ; Giordano, Silvia ; Caironi, Pietro ; Guatteri, Luca ; Raimondi, Ferdinando ; Gattinoni, Luciano ; Latini, Roberto ; Masson, Serge ; Ristagno, Giuseppe ; Pastorelli, Roberta. / Mortality prediction in patients with severe septic shock : A pilot study using a target metabolomics approach. In: Scientific Reports. 2016 ; Vol. 6.
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