Metabolic systems analysis identifies a novel mechanism contributing to shock in patients with endotheliopathy of trauma (EoT) involving thromboxane A2 and LTC4

•Endotheliopathy of Trauma (EoT) defined by an admission syndecan-1 level ≥ 40 ng/mL has been reported to be associated with significantly increased transfusion requirements and doubled 30-day mortality.•Metabolic systems analysis of the plasma metabolome using a genome scale metabolic model of the microvascular endothelial cell (iEC3006) suggests an impaired thromboxanA2 and LTC4 synthesis in EoT patients may contribute to the shock and high mortality.