Urinary protein profiling in hyperactive delirium and non-delirium cardiac surgery ICU patients

Mark van den Boogaard, Rachel Pl van Swelm, Frans Gm Russel, Suzanne Heemskerk, Johannes G van der Hoeven, Rosalinde Masereeuw, Peter Pickkers, Mark van den Boogaard, Rachel Pl van Swelm, Frans Gm Russel, Suzanne Heemskerk, Johannes G van der Hoeven, Rosalinde Masereeuw, Peter Pickkers

Abstract

Background: Suitable biomarkers associated with the development of delirium are still not known. Urinary proteomics has successfully been applied to identify novel biomarkers associated with various disease states, but its value has not been investigated in delirium patients.

Results: In a prospective explorative study hyperactive delirium patients after cardiac surgery were included for urinary proteomic analyses. Delirium patients were matched with non-delirium patients after cardiac surgery on age, gender, severity of illness score, LOS-ICU, Euro-score, C-reactive protein, renal function and aorta clamping time. Urine was collected within 24 hours after the onset of delirium. Matrix-assisted laser desorption/ionisation-time of flight mass spectrometry (MALDI-TOF MS) was applied to detect differences in the urinary proteome associated with delirium in these ICU patients. We included 10 hyperactive delirium and 10 meticulously matched non-delirium post-cardiac surgery patients. No relevant differences in the urinary excretion of proteins could be observed.

Conclusions: We conclude that MALDI-TOF MS of urine does not reveal a clear hyperactive delirium proteome fingerprint in ICU patients.

Trial registration: Clinical Trial Register number: NCT00604773.

Figures

Figure 1
Figure 1
Protein spectra and hierarchical cluster after profiling with CM10 beads. A. Protein spectra of masterpool urine (upper panel), a non-delirium patient (middle panel) and a delirium patient (lower panel). The x-axis depicts m/z values in Dalton; the y-axis shows the relative peak intensity. B. Unsupervised hierarchical clustering determines whether patient groups can be differentiated solely based on their urine protein profile. On the right hand side the samples are represented. The lengths of the horizontal lines represent the resemblance of the spectra; the shortest lines represent the most alikeness between samples. In this hierarchic cluster our masterpool can be clearly distinguished from the ICU patients, but there is no distinction between delirium and non-delirium patients.

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