Cyr A, Zhong Y, Reis SE, et al. - Researchers aimed at determining novel circulating metabolomic signatures liked with clinical outcomes following trauma. Plasma obtained during three post injury time periods (< 6h, 6h-24h, D2-D5) in critically ill trauma patients were assessed in this untargeted metabolomics and circulating plasma immune mediator analysis. Metabolomic analysis in 86 included patients led to identification of broad alterations in circulating plasma sphingolipids following blunt trauma. They identified three patient subclasses after clustering of sphingolipid patterns: (1) non-responders (no time-dependent change in sphingolipids, n = 41), (2) sphingosine/sphinganine-enhanced (n = 24), and (3) glycosphingolipid-enhanced (n = 21). Mean length of stay was longer, ventilator days were more, MOD scores were higher, and circulating levels of proinflammatory immune mediators IL-6, IL-8, IL-10, MCP1/CCL2, IP10/CXCL10, and MIG/CXCL9 were higher among non-responders than the sphingolipid enhanced subclasses, despite similar injury severity scores. These findings suggest a possible correlation between sphingolipid metabolism and the immune response to trauma.