Past Experiences for Future Applications of Metabolomics in Critically Ill Patients with Sepsis and Septic Shocks

A disruption of several metabolic pathways in critically ill patients with sepsis indicates that metabolomics might be used as a more precise tool for sepsis and septic shock when compared with the conventional biomarkers. This article provides information regarding metabolomics studies in sepsis and septic shock patients. It has been shown that a variety of metabolomic pathways are altered in sepsis and septic shock, including amino acid metabolism, fatty acid oxidation, phospholipid metabolism, glycolysis, and tricarboxylic acid cycle. Based upon this comprehensive review, here, we demonstrate that metabolomics is about to change the world of sepsis biomarkers, not only for its utilization in sepsis diagnosis, but also for prognosticating and monitoring the therapeutic response. Additionally, the future direction regarding the establishment of studies integrating metabolomics with other molecular modalities and studies identifying the relationships between metabolomic profiles and clinical characteristics to address clinical application are discussed in this article. All of the information from this review indicates the important impact of metabolomics as a tool for diagnosis, monitoring therapeutic response, and prognostic assessment of sepsis and septic shock. These findings also encourage further clinical investigations to warrant its use in routine clinical settings.

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Faculty Opinions recommendation of Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718312921.793493679 ◽

2014 ◽

Author(s):

Niranjan Kissoon ◽

Srinivas Murthy

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

New Zealand ◽

Critically Ill ◽

Critically Ill Patients ◽

Sepsis And Septic Shock

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Chronically critically ill patients: different behavior in severe sepsis and septic shock?

Intensive Care Medicine Experimental ◽

10.1186/2197-425x-3-s1-a83 ◽

2015 ◽

Vol 3 (S1) ◽

Author(s):

DH Prevedello ◽

A Rea-Neto ◽

HA Teive ◽

LA Tannous ◽

RAO Deucher ◽

...

Keyword(s):

Septic Shock ◽

Severe Sepsis ◽

Critically Ill ◽

Critically Ill Patients ◽

Chronically Critically Ill ◽

Sepsis And Septic Shock

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Population Pharmacokinetics and Monte Carlo Dosing Simulations of Meropenem during the Early Phase of Severe Sepsis and Septic Shock in Critically Ill Patients in Intensive Care Units

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.04166-14 ◽

2015 ◽

Vol 59 (6) ◽

pp. 2995-3001 ◽

Cited By ~ 30

Author(s):

Sutep Jaruratanasirikul ◽

Suriyan Thengyai ◽

Wibul Wongpoowarak ◽

Thitima Wattanavijitkul ◽

Kanyawisa Tangkitwanitjaroen ◽

...

Keyword(s):

Septic Shock ◽

Monte Carlo ◽

Severe Sepsis ◽

Critically Ill ◽

Critically Ill Patients ◽

Early Phase ◽

Volume Of Distribution ◽

Therapeutic Success ◽

Altered Pharmacokinetic ◽

Sepsis And Septic Shock

ABSTRACTPathophysiological changes during the early phase of severe sepsis and septic shock in critically ill patients, resulting in altered pharmacokinetic (PK) patterns for antibiotics, are important factors influencing therapeutic success. The aims of this study were (i) to reveal the population PK parameters and (ii) to assess the probability of target attainment (PTA) for meropenem. The PK studies were carried out following administration of 1 g of meropenem every 8 h during the first 24 h of severe sepsis and septic shock in nine patients, and a Monte Carlo simulation was performed to determine the PTA of achieving 40% exposure time during which the free plasma drug concentration remains above the MIC (fT>MIC) and 80%fT>MIC. The volume of distribution (V) and total clearance (CL) of meropenem in these patients were 23.7 liters and 7.82 liters/h, respectively. For pathogens with MICs of 4 μg/ml, the PTAs of 40%fT>MICfollowing administration of meropenem as a 1-h infusion of 1 g every 8 h and a 4-h infusion of 0.5 g every 8 h were 92.52% and 90.29%, respectively. For pathogens with MICs of 2 μg/ml in immunocompromised hosts, the PTAs of 80%fT>MICfollowing administration of 1-h and 4-h infusions of 2 g of meropenem every 8 h were 84.32% and 94.72%, respectively. These findings indicated that theVof meropenem was greater and the CL of meropenem was lower than the values obtained in a previous study with healthy subjects. The maximum recommended dose, i.e., 2 g of meropenem every 8 h, may be required for treatment of life-threatening infections in this patient population.

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