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Updated: Nov 29, 2025
Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
Published on: November 29, 2024
Title NMR-based metabolic profiling provides diagnostic and prognostic information in critically ill children with
Arturas Grauslys1, Marie M Phelan1, Caroline Broughton2
1University of Liverpool Institute of Integrative Biology, Biosciences Building, Crown Street, Liverpool, L69 7ZB, UK.
Insights
Nuclear magnetic resonance (NMR) metabolomics can differentiate critically ill children with post-operative inflammation, bacterial infection, and viral infection. This technique also distinguishes sepsis with organ dysfunction from infection without organ dysfunction.
Area of Science:
- Biochemistry and Molecular Biology
- Pediatric Critical Care Medicine
- Metabolomics
Background:
- Sepsis, a life-threatening condition characterized by organ dysfunction due to infection, is clinically challenging to differentiate from other conditions like post-operative inflammation or simple infection.
- Accurate and timely diagnosis is crucial for effective treatment and improved outcomes in critically ill children.
- Existing diagnostic methods may not sufficiently distinguish between different etiological causes of critical illness in children.
Purpose of the Study:
- To investigate the utility of 1D proton nuclear magnetic resonance (1D 1H NMR) metabolomics in differentiating various conditions in critically ill children.
- To compare metabolic profiles of children with post-operative inflammation, bacterial infection, viral infection, and sepsis with or without organ dysfunction.
- To assess the diagnostic accuracy of NMR metabolomics in distinguishing these conditions.
Main Methods:
- Plasma samples were collected from critically ill children.
- 1D 1H NMR spectroscopy was performed on plasma samples.
- Principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) were used for data analysis and model building.
- Area under the receiver operating characteristic curve (AUC) was calculated to evaluate model performance.
Main Results:
- Univariate analysis showed significant differences between control and infection groups (bacterial and viral).
- High diagnostic accuracy was achieved in differentiating bacterial infection from controls (AUC = 0.94) and viral infection from controls (AUC = 0.83).
- Discrimination between bacterial and viral infections showed a moderate AUC of 0.78.
- Distinguishing sepsis with organ dysfunction from infection without organ dysfunction yielded a moderate AUC of 0.73.
Conclusions:
- NMR metabolomics effectively differentiates critically ill children with post-operative inflammation (no infection) from those with bacterial or viral infections.
- This metabolomic approach shows promise in distinguishing between sepsis with organ dysfunction and infection without organ dysfunction in pediatric patients.
- NMR-based metabolomics offers a valuable tool for improving diagnostic accuracy in complex pediatric critical care scenarios.
Abstract:
Sepsis, defined as life-threatening organ dysfunction caused by infection is difficult to distinguish clinically from infection or post-operative inflammation. We hypothesized that in a heterogeneous group of critically ill children, there would be different metabolic profiles between post-operative inflammation, bacterial and viral infection and infection with or without organ dysfunction. 1D 1H nuclear magnetic resonance spectra were acquired in plasma samples from critically ill children. We included children with bacterial (n = 25) and viral infection (n = 30) and controls (n = 58) (elective cardiac surgery without infection). Principal component analysis was used for data exploration and partial least squares discriminant analysis models for the differences between groups. Area under receiver operating characteristic curve (AUC) values were used to evaluate the models. Univariate analysis demonstrated differences between controls and bacterial and viral infection. There was excellent discrimination between bacterial and control (AUC = 0.94), and viral and control (AUC = 0.83), with slightly more modest discrimination between bacterial and viral (AUC = 0.78). There was modest discrimination (AUC = 0.73) between sepsis with organ dysfunction and infection with no organ dysfunction. In critically ill children, NMR metabolomics differentiates well between those with a post-operative inflammation but no infection, and those with infection (bacterial and viral), and between sepsis and infection.
