Substantial subjective gains are observed when this new measure is utilized instead of NMR in the Two Loop Search. Such records are often crackled due to the shrinkage of the coating. It is impossible to read such records. PETER GOTCHER OF TOPSPIN MEDIA. Carpenters Can. Saturday, October 4, 1:00 pm – 2:00 pm.

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1, 2, 3 and 2 1Pulmonary, Department of Medicine, Critical Care and Occupational Medicine, University of Iowa Hospital and Clinics, Iowa City, IA, USA 2Critical Care and Acute Care Surgery Division, Department of Surgery, University of Minnesota, Minneapolis, MN, USA 3Pulmonary and Critical Care Division, Department of Medicine, University of Minnesota, Minneapolis, MN, USA Correspondence should be addressed to Received 20 July 2017; Revised 24 September 2017; Accepted 16 October 2017; Published 17 December 2017 Academic Editor: Frederik Trinkmann. Abstract We aimed to investigate whether metabolomic analysis can discriminate acute respiratory failure due to COPD exacerbation from respiratory failure due to heart failure and pneumonia.

Since COPD exacerbation is often overdiagnosed, we focused on those COPD exacerbations that were severe enough to require noninvasive mechanical ventilation. We enrolled stable COPD subjects and patients with acute respiratory failure requiring noninvasive mechanical ventilation due to COPD, heart failure, and pneumonia. We excluded subjects with history of both COPD and heart failure and patients with obstructive sleep apnea and obstructive lung disease other than COPD. We performed metabolomics analysis using NMR.

We constructed partial least squares discriminant analysis (PLS-DA) models to distinguish metabolic profiles. Serum (, R 2 = 0.397, Q 2 = 0.058) and urine metabolic profiles (, R 2 = 0.419, Q 2 = 0.142) were significantly different between the four diagnosis groups by PLS-DA. After excluding stable COPD patients, the metabolomes of the various respiratory failure groups did not cluster separately in serum (, R 2 = 0.631, Q 2 = 0.246) or urine (, R 2 = 0.602, Q 2 = −0.134). However, several metabolites in the serum were reduced in patients with COPD exacerbation and pneumonia.

We did not find a metabolic profile unique to COPD exacerbation, but we were able to clearly and reliably distinguish stable COPD patients from patients with respiratory failure in both serum and urine.