• Luis Servià, Mariona Jové, Joaquim Sol, Reinald Pamplona, Mariona Badia, Neus Montserrat, Manuel Portero-Otin, and Javier Trujillano.
• Critical Care Unit, University Hospital Arnau de Vilanova, 25198, Lleida, Spain.
• Scand J Trauma Resus. 2019 May 22; 27 (1): 56.

BackgroundWe wanted to define metabolomic patterns in plasma to predict a negative outcome in severe trauma patients.MethodsA prospective pilot study was designed to evaluate plasma metabolomic patterns, established by liquid chromatography coupled to mass spectrometry, in patients allocated to an intensive care unit (in the University Hospital Arnau de Vilanova, Lleida, Spain) in the first hours after a severe trauma (n = 48). Univariate and multivariate statistics were employed to establish potential predictors of mortality.ResultsPlasma of patients non surviving to trauma (n = 5) exhibited a discriminating metabolomic pattern, involving basically metabolites belonging to fatty acid and catecholamine synthesis as well as tryptophan degradation pathways. Thus, concentration of several metabolites exhibited an area under the receiver operating curve (ROC) higher than 0.84, including 3-indolelactic acid, hydroxyisovaleric acid, phenylethanolamine, cortisol, epinephrine and myristic acid. Multivariate binary regression logistic revealed that patients with higher myristic acid concentrations had a non-survival odds ratio of 2.1 (CI 95% 1.1-3.9).ConclusionsSpecific fatty acids, catecholamine synthesis and tryptophan degradation pathways could be implicated in a negative outcome after trauma. The metabolomic study of severe trauma patients could be helpful for biomarker proposal.

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