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Targeted plasma met...
Targeted plasma metabolomics in resuscitated comatose out-of-hospital cardiac arrest patients
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- Paulin Beske, Rasmus (författare)
- Copenhagen University Hospital
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- Henriksen, Hanne H. (författare)
- Copenhagen University Hospital
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- Obling, Laust (författare)
- Copenhagen University Hospital
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- Kjærgaard, Jesper (författare)
- Copenhagen University Hospital
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- Bro-Jeppesen, John (författare)
- Aarhus University Hospital
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- Nielsen, Niklas (författare)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups
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- Johanson, Pär I. (författare)
- Copenhagen University Hospital,University of Copenhagen
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- Hassager, Christian (författare)
- Copenhagen University Hospital,University of Copenhagen
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(creator_code:org_t)
- Elsevier BV, 2022
- 2022
- Engelska 9 s.
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572. ; 179, s. 163-171
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death. Even if successfully resuscitated, mortality remains high due to ischemic and reperfusion injury (I/R). The oxygen deprivation leads to a metabolic derangement amplified upon reperfusion resulting in an uncontrolled generation of reactive oxygen species in the mitochondria triggering cell death mechanisms. The understanding of I/R injury in humans following OHCA remains sparse, with no existing treatment to attenuate the reperfusion injury. Aim: To describe metabolic derangement in patients following resuscitated OHCA. Methods: Plasma from consecutive resuscitated unconscious OHCA patients drawn at hospital admission were analyzed using ultra-performance-liquid-mass-spectrometry. Sixty-one metabolites were prespecified for quantification and studied. Results: In total, 163 patients were included, of which 143 (88%) were men, and the median age was 62 years (53–68). All measured metabolites from the tricarboxylic acid (TCA) cycle were significantly higher in non-survivors vs. survivors (180-days survival). Hierarchical clustering identified four clusters (A-D) of patients with distinct metabolic profiles. Cluster A and B had higher levels of TCA metabolites, amino acids and acylcarnitine species compared to C and D. The mortality was significantly higher in cluster A and B (A:62% and B:59% vs. C:21 % and D:24%, p < 0.001). Cluster A and B had longer time to return of spontaneous circulation (A:33 min (21–43), B:27 min (24–35), C:18 min (13–28), and D:18 min (12–25), p < 0.001). Conclusion: Circulating levels of metabolites from the TCA cycle best described the variance between survivors and non-survivors. Four different metabolic phenotypes with significantly different mortality were identified.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Lipid metabolites
- Metabolomics
- Out-of-hospital cardiac arrest
- Tricarboxylic acid
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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