Trauma-induced sepsis: Trying to catch it before it erupts
November 5, 2013 § Leave a comment
Patients suffering from traumatic injuries in an intensive care unit often are at risk of sepsis, a severe whole-body inflammatory response to an infection that can lead to death. But there aren’t good ways of identifying those patients most at risk of sepsis. In a recent paper in the journal Analytical Chemistry, researchers described a method based on metabolic phenotyping to help catch patients before they succumb to full-blown sepsis.
The molecular steps of how trauma-induced sepsis evolves in patients are not known, says Benjamin Blaise at the Hospices Civils de Lyon in France who spearheaded the work. Also, much of the research on trauma-induced sepsis has been done in animal models and not in humans.
The researchers opted to use nuclear magnetic resonance, or NMR, spectroscopy because they didn’t have any idea what molecules were involved. NMR-based metabolic phenotyping takes a look at all the changes happening at the molecular level, so the researchers can use the approach to find potential biomarkers that are characteristic for trauma induced sepsis, explains Blaise.
The researchers carried out NMR spectroscopic analysis of plasma samples from 21 severely injured patients within hours of their admission into an ICU. From their analysis, the researchers identified eight indicators of metabolic pathways, which included valine, citrate, aspartate, allantoin and hydroxybutyrate, which seem to change in those patients who developed sepsis but not in those who didn’t. These indicators point to metabolic hotspots where the researchers can drill deeper to find candidate biomarkers, which is what Blaise and his colleagues are now doing. “One could imagine the quantification of one or a few metabolites, upon the admission of traumatized patients, to estimate the risk of sepsis development,” notes Blaise.
There are still challenges with the method. One is that NMR spectrometers are expensive, but the instruments may become more common in hospitals as they are made smaller and more affordable. Researchers also need access to more plasma samples to make sure the method holds across many different kinds of samples. Blaise and his colleagues are working on enrolling more patients to see how their method performs in a larger group of ICU patients.