The study, led by Beata Mickiewicz and colleagues from the University of Calgary and University of Alberta, took serum and plasma samples from children aged 1-23 months presenting with sepsis to the PICU (n=46) or who presented to the paediatric emergency department with (n=58) and without sepsis (n=19).
From each serum sample 59 metabolites were detected and 57 inflammatory protein-mediators were recognised and quantified in the plasma samples. Twenty-one metabolites and 15 inflammatory protein-mediators were responsible for the separation between the PICU-sepsis patients and the PED-sepsis patients.
The results were compared to previously published results for older children aged 2-17 years old. Seven metabolites and their concentration changes common to both groups were used to create the sepsis triage model: increased level of dimethylamine, mannose, 3-methyl-2-oxovalerate and 3-hydroxyisovalerate, and decreased concentrations of alanine, O-acetylcholine and acetate. None of the inflammatory protein-mediators were common to both groups. The biopattern was internally validated and requires further validation.
These seven metabolites can be described as a biopattern for sepsis triage in children, say the researchers, and could potentially inform triage in the ED, as it reflects altered energy metabolism in children most affected by sepsis.
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