Abstract
IntroductionSeptic 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.MethodsSerum 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). 1H 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.ResultsBy 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.ConclusionsOur 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-014-0729-0) contains supplementary material, which is available to authorized users.
Highlights
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
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 intensive care unit (ICU)
The study includes samples collected from septic shock patients who met criteria for septic shock as defined by the American- European consensus statement on sepsis [20,21] and samples obtained from ICU control patients (ICU patients with the systemic inflammatory response syndrome (SIRS) but not suspected of having an infection)
Summary
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. 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). Integrated and multifaceted medical approaches supported by effective diagnostic tools, such as a combination of various biomarkers, may improve the identification and the prognosis for sepsis in intensive care units (ICUs) [3,9]. Such an integrated approach, based on merging different data sets, could create broader and more detailed insight into the nature of the disease than can be achieved using one individual approach
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