Metabolomics and Precision Medicine in Trauma: The State of the Field.

Autor:	Jayaraman SP; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Anand RJ; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., DeAntonio JH; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Mangino M; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Aboutanos MB; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Kasirajan V; Department of Surgery, Division of Cardiothoracic Surgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Ivatury RR; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Valadka AB; Department of Neurosurgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Glushakova O; Department of Neurosurgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Hayes RL; Department of Neurosurgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia.; Center of Innovative Research, Banyan Biomarkers, Inc., Alachua, Florida., Bachmann LM; Department of Pathology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia., Brophy GM; Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Contaifer D; Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Warncke UO; Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Brophy DF; Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia., Wijesinghe DS; Department of Surgery, Division of Acute Care Surgical Services, School of Medicine, Virginia Commonwealth University, Richmond, Virginia.; Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia.; da Vinci Center, Virginia Commonwealth University, Richmond, Virginia.
Jazyk:	angličtina
Zdroj:	Shock (Augusta, Ga.) [Shock] 2018 Jul; Vol. 50 (1), pp. 5-13.
DOI:	10.1097/SHK.0000000000001093
Abstrakt:	Trauma is a major problem in the United States. Mortality from trauma is the number one cause of death under the age of 45 in the United States and is the third leading cause of death for all age groups. There are approximately 200,000 deaths per year due to trauma in the United States at a cost of over $671 billion in combined healthcare costs and lost productivity. Unsurprisingly, trauma accounts for approximately 30% of all life-years lost in the United States. Due to immense development of trauma systems, a large majority of trauma patients survive the injury, but then go on to die from complications arising from the injury. These complications are marked by early and significant metabolic changes accompanied by inflammatory responses that lead to progressive organ failure and, ultimately, death. Early resuscitative and surgical interventions followed by close monitoring to identify and rescue treatment failures are key to successful outcomes. Currently, the adequacy of resuscitation is measured using vital signs, noninvasive methods such as bedside echocardiography or stroke volume variation, and other laboratory endpoints of resuscitation, such as lactate and base deficit. However, these methods may be too crude to understand cellular and subcellular changes that may be occurring in trauma patients. Better diagnostic and therapeutic markers are needed to assess the adequacy of interventions and monitor responses at a cellular and subcellular level and inform clinical decision-making before complications are clinically apparent. The developing field of metabolomics holds great promise in the identification and application of biochemical markers toward the clinical decision-making process.
Databáze:	MEDLINE
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