TY - JOUR
T1 - Metabolomics in COPD Acute Respiratory Failure Requiring Noninvasive Positive Pressure Ventilation
AU - Fortis, Spyridon
AU - Lusczek, Elizabeth R.
AU - Weinert, Craig R.
AU - Beilman, Greg J.
N1 - Publisher Copyright:
© 2017 Spyridon Fortis et al.
PY - 2017
Y1 - 2017
N2 - We aimed to investigate whether metabolomic analysis can discriminate acute respiratory failure due to COPD exacerbation from respiratory failure due to heart failure and pneumonia. Since COPD exacerbation is often overdiagnosed, we focused on those COPD exacerbations that were severe enough to require noninvasive mechanical ventilation. We enrolled stable COPD subjects and patients with acute respiratory failure requiring noninvasive mechanical ventilation due to COPD, heart failure, and pneumonia. We excluded subjects with history of both COPD and heart failure and patients with obstructive sleep apnea and obstructive lung disease other than COPD. We performed metabolomics analysis using NMR. We constructed partial least squares discriminant analysis (PLS-DA) models to distinguish metabolic profiles. Serum (p=0.001, R 2 = 0.397, Q 2 = 0.058) and urine metabolic profiles (p<0.001, R 2 = 0.419, Q 2 = 0.142) were significantly different between the four diagnosis groups by PLS-DA. After excluding stable COPD patients, the metabolomes of the various respiratory failure groups did not cluster separately in serum (p=0.2, R 2 = 0.631, Q 2 = 0.246) or urine (p=0.065, R 2 = 0.602, Q 2 = -0.134). However, several metabolites in the serum were reduced in patients with COPD exacerbation and pneumonia. We did not find a metabolic profile unique to COPD exacerbation, but we were able to clearly and reliably distinguish stable COPD patients from patients with respiratory failure in both serum and urine.
AB - We aimed to investigate whether metabolomic analysis can discriminate acute respiratory failure due to COPD exacerbation from respiratory failure due to heart failure and pneumonia. Since COPD exacerbation is often overdiagnosed, we focused on those COPD exacerbations that were severe enough to require noninvasive mechanical ventilation. We enrolled stable COPD subjects and patients with acute respiratory failure requiring noninvasive mechanical ventilation due to COPD, heart failure, and pneumonia. We excluded subjects with history of both COPD and heart failure and patients with obstructive sleep apnea and obstructive lung disease other than COPD. We performed metabolomics analysis using NMR. We constructed partial least squares discriminant analysis (PLS-DA) models to distinguish metabolic profiles. Serum (p=0.001, R 2 = 0.397, Q 2 = 0.058) and urine metabolic profiles (p<0.001, R 2 = 0.419, Q 2 = 0.142) were significantly different between the four diagnosis groups by PLS-DA. After excluding stable COPD patients, the metabolomes of the various respiratory failure groups did not cluster separately in serum (p=0.2, R 2 = 0.631, Q 2 = 0.246) or urine (p=0.065, R 2 = 0.602, Q 2 = -0.134). However, several metabolites in the serum were reduced in patients with COPD exacerbation and pneumonia. We did not find a metabolic profile unique to COPD exacerbation, but we were able to clearly and reliably distinguish stable COPD patients from patients with respiratory failure in both serum and urine.
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U2 - 10.1155/2017/9480346
DO - 10.1155/2017/9480346
M3 - Article
C2 - 29391845
AN - SCOPUS:85042176248
SN - 1198-2241
VL - 2017
JO - Canadian Respiratory Journal
JF - Canadian Respiratory Journal
M1 - 9480346
ER -