Artikel
Lipidomic changes after trauma in occult hypoperfusion: an analysis in a standardized porcine polytrauma model
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Veröffentlicht: | 25. Oktober 2022 |
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Gliederung
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Objectives: Occult hypoperfusion (OH) describes the absence of sufficient microcirculation despite normal vital signs. It is known to be associated with later complications in severely injured patients. Lipids are involved in post-traumatic inflammatory response. We hypothesized that lipids may also contribute to the systemic physiological process during resuscitation and recovery after trauma. The purpose of this study is investigating the relation between responsiveness to resuscitation and lipidomic changes after trauma in standardized polytrauma porcine model.
Methods: 25 male pigs were exposed a combined injury of blunt chest trauma, a liver laceration, controlled hemorrhagic shock, and femoral shaft fracture. After 60 minutes, animals received resuscitation and fracture stabilization. Venous blood was taken regularly from baseline until 6 hours post trauma. Animals were divided into 2 groups based on serum lactate level at the end point as an indicator of responsiveness to resuscitation (< 2mmol / L: responder (R) group , >= 2 mmol / L: occult hypoperfusion (OH) group). 233 specific lipids were analyzed using mass spectrometry.
Results and conclusion: We have observed different patterns of systemic lipid liberation in animals with occult hypoperfusion. Acylcarnitines (AcCas) showed a significant increase at 1h in both groups (R group: 0.38 ± 0.07 vs 1.01 ± 0.19, p < 0.001, OH group: 0.20 ± 0.05 vs 0.77 ± 0.13, p = 0.010). Six subgroups: Phosphatidylcholines (PCs), Lysophosphatidylcholines (LPCs), Ceramides (Cers), Phosphatidylethanolamines (PEs), Phosphatidylglycerols (PGs), and Diacylglycerols (DAGs) showed a significant increase in R group at 2h (PCs: 716.27 ± 48.78 vs 1012.32 ± 96.50, p = 0.005; LPCs: 250.88 ± 12.55 vs 343.79 ± 31.30, p = 0.011; Cers: 2.52 ± 0.36 vs 5.03 ± 1.13, p = 0.012; PEs: 9.00 ± 0.93 vs 14.11 ± 1.09, p = 0.003; PGs: 0.64 ± 0.06 vs 1.19 ± 0.19, p < 0.001; DAGs: 126.65 ± 16.72 vs 201.41 ± 23.53, p = 0.040), which was not present in insufficiently resuscitated animals.
Significant increase of AcCas concentration observed in both groups at 1h suggested that this lipid has a potential to become a common biomarker indicating the traumatized condition. The results of six sub lipid groups, which increased at 2h only in R group, indicated that they have a potential to become a biomarker to predict the posttraumatic course.