Evidence mapPaperPMID 39740607Full record

ArticleSurgery2025

Acute perioperative alterations in metabolism: A pilot study using mass spectrometry-based metabolomics.

Keri A Seymour, Madison Strain, Allison Ashley-Koch, Michael J Muehlbauer, Olga R Ilkayeva, Tabitha K George, Demitrius Hill, Mark Ellison, Satoru Ito, Sandhya Lagoo-Deenadayalan and 7 more

Abstract read
In one paragraph

Article in Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Keri A SeymourDepartment of Surgery, Duke University School of Medicine, Durham, NC. Electronic address: keri.seymour@duke.edu.
Madison StrainUniversity Program in Genetics and Genomics, Duke University School of Medicine, Durham, NC; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC.
Allison Ashley-KochDuke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC; Department of Medicine (Nephrology), Duke University School of Medicine, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC.
Michael J MuehlbauerDuke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC.
Olga R IlkayevaDuke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC; Department of Medicine (Endocrinology), Duke University School of Medicine, Durham, NC.
Tabitha K GeorgeDuke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC.
Demitrius HillDuke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC.
Mark EllisonDepartment of Surgery, Duke University School of Medicine, Durham, NC.
Satoru ItoDepartment of Surgery, Duke University School of Medicine, Durham, NC.
Sandhya Lagoo-DeenadayalanDepartment of Surgery, Duke University School of Medicine, Durham, NC.
Jennifer K PlichtaDepartment of Surgery, Duke University School of Medicine, Durham, NC.
J Todd PurvesDepartment of Surgery, Duke University School of Medicine, Durham, NC.
Julie K M ThackerDepartment of Surgery, Duke University School of Medicine, Durham, NC.
Justin NalleyDepartment of Surgery, Duke University School of Medicine, Durham, NC.
Allan D KirkDepartment of Surgery, Duke University School of Medicine, Durham, NC.
E Shelley HwangDepartment of Surgery, Duke University School of Medicine, Durham, NC.
James R BainDuke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC; Department of Medicine (Endocrinology), Duke University School of Medicine, Durham, NC.

Funding

SPECIFIC GENE AND SMALL MOLECULE DELIVERY TO CELLSP01DK058398 · UNIVERSITY OF TEXAS SW MED CTR/DALLAS · 2000 to 2005
$6.9M
Pilot & Feasibility ProgramP30DK124723 · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2025 to 2025
$1.6M
Building Interdisciplinary Research Careers in Women's Health (K12)K12AR084231 · DUKE UNIVERSITY · 2025 to 2025
$620k
Biomarkers of Dietary Intake and Exposure Data Coordinating CenterU24DK129557 · DUKE UNIVERSITY · 2025 to 2025
$523k
National institute of aging P30 AG027816NIAMS NIH HHS K12 AR084231NIDDK NIH HHS P01 DK058398NIDDK NIH HHS P01 DK078669NIDDK NIH HHS P30 DK124723NIDDK NIH HHS R01 DK117491NIDDK NIH HHS U24 DK129557
6 · The paper itself

Abstract

objectiveTo characterize early physiologic stresses imposed by surgery by applying metabolomic analyses to deeply phenotype pre- and postoperative plasma and urine of patients undergoing elective surgical procedures.

backgroundPatients experience perioperative stress through depletion of metabolic fuels. Bowel stasis or injury might allow more microbiome-derived uremic toxins to enter the blood, while the liver and kidney are simultaneously clearing analgesic and anesthetic drugs. Metabolomics provides a broad-scale snapshot of small-molecule chemicals generated in vital energetic and detoxification pathways, enabling a mechanistic understanding of surgical stressors.

methodsWe performed metabolomic analysis of paired preoperative and early-recovery plasma (n = 34) and urine (n = 35) from patients who underwent elective surgeries, spanning cardiovascular, gastrointestinal, hernia, oncologic, and urologic procedures. Mass spectrometry-based metabolomics analyses were performed together with the analysis of select metabolites and macromolecules via conventional clinical assays.

resultsFuel stress during elective surgery manifested in changes across all major metabolic pathways, encompassing lipolysis, glycolysis-Krebs cycle, ketogenesis, and glycogenolysis. A common signature of enhanced amino acid oxidation and urea-cycle activity emerged, which was especially pronounced in patients given citrulline boluses before visceral procedures. Excretion of amino acid-derived catabolite toxins increased during surgery, notably those derived from gut microbes, as did an extract of disposable surgical plasticware, bis(2-ethylhexyl)phthalate.

conclusionElective surgery imposes broad-scale early and measurable metabolic changes. The use of citrulline-enriched preoperative carbohydrate drinks needs further study to limit metabolic burden. Attention to perioperative nutrition and intraoperative control of gut-microbial toxins might reduce metabolic derangements and lead to better postoperative outcomes.

Indexed as

Elective Surgical ProceduresMetabolomicsStress, PhysiologicalAdultAgedBiomarkersFemaleHumansMaleMass SpectrometryMiddle AgedPerioperative PeriodPilot ProjectsBiomarkers

Identifiers

PMID39740607
PMCPMC11936720

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.