Evaluation of endogenous and exogenous energy utilization by metabolomics in the early phase energy metabolism of critically ill patients

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K09390
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Chiba University
• Principal Investigator: Oshima Taku 千葉大学, 災害治療学研究所, 准教授 (50375789)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: Metabolomics / 重症患者 / エネルギー代謝 / 同化反応 / 異化反応

Outline of Final Research Achievements

The purpose of this study was to show that metabolomics can help determine the optimal timing to start administering nutrition in critically ill patients, which has not been clearly defined to date. Untargeted metabolomics was performed using serum samples of ten critically ill patients, collected for 7 consecutive days had after admission to the ICU. The energy expenditurs of the patients were measured by indirect calorimetry, and laboratory findings and vital signs were also recorded. We demonstrated that metabolomes associated with changes in nutritional metabolism according to the evolution of the critical illness increased or decreased over time, and that the patterns differed between septic and non-septic patients. The relationship between the metabolomic change and energy consumption and other clinical characteristics are currently under further investigation.

Free Research Field

救急集中治療医学

Academic Significance and Societal Importance of the Research Achievements

本研究では重症患者の早期の代謝動態変化を，網羅的metabolomicsによりICU入室から７日間連続採取した検体を用いて，症例数は10例と少ないものの詳細に解析することができた．Metabolomeの経時的な変化に加え，敗血症と非敗血症では検出されるmetabolomeのパターンが変わることが判明した，これは，栄養投与を開始する際，病態についても考慮が必要となることを示唆している．Metabolomicsの結果と臨床兆候との関連性については解析中だが、バイタルサインや臨床法検査の結果などとの関連が見出せれば，より簡便な指標で栄養投与のタイミングを測ることができるようになる．