Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Jan 15;36(2):212-221.
doi: 10.1089/neu.2018.5674. Epub 2018 Aug 13.

Novel Metabolomic Comparison of Arterial and Jugular Venous Blood in Severe Adult Traumatic Brain Injury Patients and the Impact of Pentobarbital Infusion

Affiliations
Free PMC article
Observational Study

Novel Metabolomic Comparison of Arterial and Jugular Venous Blood in Severe Adult Traumatic Brain Injury Patients and the Impact of Pentobarbital Infusion

Stephanie M Wolahan et al. J Neurotrauma. .
Free PMC article

Abstract

Treatment of severe traumatic brain injury (TBI) in the intensive care unit focuses on controlling intracranial pressure, ensuring sufficient cerebral perfusion, and monitoring for secondary injuries. However, there are limited prognostic tools and no biomarkers or tests of the evolving neuropathology. Metabolomics has the potential to be a powerful tool to indirectly monitor evolving dysfunctional metabolism. We compared metabolite levels in simultaneously collected arterial and jugular venous samples in acute TBI patients undergoing intensive care as well as in healthy control volunteers. Our results show that, first, many circulating metabolites are decreased in TBI patients compared with healthy controls days after injury; both proline and hydroxyproline were depleted by ≥60% compared with healthy controls, as was gluconate. Second, both arterial and jugular venous plasma metabolomic analysis separates TBI patients from healthy controls and shows that distinct combinations of metabolites are driving the group separation in the two blood types. Third, TBI patients under heavy sedation with pentobarbital at the time of blood collection were discernibly different from patients not receiving pentobarbital. These results highlight the importance of accounting for medications in metabolomics analysis. Jugular venous plasma metabolomics shows potential as a minimally invasive tool to identify and study dysfunctional cerebral metabolism after TBI.

Keywords: human; jugular venous blood; metabolomics; pentobarbital.

Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b>
FIG. 1.
Visualization of changes in metabolites between groups by volcano plot in (A) arterial and (B) jugular venous blood. Volcano plots visualize the fold change between groups as a function of the significance level of the statistical test performed. Metabolites above the horizontal dashed line are considered to significantly change between groups (false discovery rate [FDR] adjusted p value <0.05). Vertical dotted lines indicate, from left to right, fold changes of 0.6, 0.75, 1.33, and 1.66.
<b>FIG. 2.</b>
FIG. 2.
Principal component scores plots for (A) arterial and (B) jugular venous blood plasma samples (closed circle = traumatic brain injury [TBI]; circle-plus = healthy controls [HC]). The 95% confidence ellipse and group averages are illustrated with solid and dotted gray lines for TBI and HC, respectively (horizontal and vertical error bars are the 95% confidence intervals for the group averages in PC1 and PC2, respectively).
<b>FIG. 3.</b>
FIG. 3.
(A) Principal component loading scalar projection visualization for arterial (Art, left) and jugular venous (Jug, right) blood plasma samples. The shading of the tile plot is equal to the metabolite vector scalar projection; those metabolites with negative scalar projections (i.e., toward the traumatic brain injury [TBI] group) have a minus sign in the corresponding tile. (B) Principal component loadings ratio of scalar projection divided by offset for Art (left) and Jug venous (right) blood plasma samples. The shading of the tile plot corresponds to the base 10 logarithmic transform of the ratio of the scalar projection and the scalar offset.
<b>FIG. 4.</b>
FIG. 4.
Principal components scores plot for (A) arterial and (B) jugular venous blood plasma samples (closed square = traumatic brain injury [TBI] + pentobarbital [PTB]; square-plus = TBI; open square = healthy controls). The 95% confidence ellipse and group averages are illustrated with solid and dashed gray lines for TBI + PTB and TBI, respectively (horizontal and vertical error bars are the 95% confidence intervals for the group averages in PC1 and PC2, respectively).
<b>FIG. 5.</b>
FIG. 5.
(A) Principal component loading scalar projection visualization for jugular venous blood plasma samples between traumatic brain injury (TBI) + pentobarbital (PTB) and TBI groups. The shading of the tile plot is equal to the metabolite vector scalar projection; those metabolites with negative scalar projections (toward the TBI + PTB group) have a minus sign in the corresponding tile. (B) Principal component loadings ratio of scalar projection divided by offset for jugular venous blood plasma samples between TBI + PTB and TBI groups. The shading of the tile plot corresponds to the base 10 logarithmic transform of the ratio of the scalar projection and the scalar offset.

Similar articles

See all similar articles

Cited by 1 article

Publication types

Feedback