DSpace university logo mark
Advanced Search
Japanese | English 

NAOSITE : Nagasaki University's Academic Output SITE > University Hospital > Articles in academic journal >

Association between endotoxemia and enterocyte injury and clinical course in patients with gram-positive septic shock


File Description SizeFormat
Medicine98_16452.pdf329.67 kBAdobe PDFView/Open

Title: Association between endotoxemia and enterocyte injury and clinical course in patients with gram-positive septic shock
Authors: Sekino, Motohiro / Funaoka, Hiroyuki / Sato, Shuntaro / Egashira, Takashi / Inoue, Haruka / Yano, Rintaro / Matsumoto, Sojiro / Ichinomiya, Taiga / Higashijima, Ushio / Matsumoto, Shuhei / Hara, Tetsuya
Issue Date: 1-Jul-2019
Publisher: Wolters Kluwer Health, Inc.
Citation: Medicine, 98(28), e16452; 2019
Abstract: Endotoxemia often occurs in patients with gram-positive infections. The possible mechanism is thought to be bacterial translocation after enterocyte hypoperfusion injury. However, the association between endotoxemia and enterocyte injury among patients with gram-positive septic shock has never been assessed. The aim of this study was to evaluate the association between endotoxemia and enterocyte injury in gram-positive septic shock patients and to evaluate the association among endotoxemia, subsequent clinicalcourse, and other related factors.This was a posthoc analysis of a prospective observational study that evaluated the capability of intestinal fatty acid-binding protein(I-FABP), an indicator of enterocyte injury, to predict mortality. Among 57 patients in septic shock, those whose causative microorganisms were gram positive were included. The correlation between endotoxin activity (EA), which indicates endotoxemia,and I-FABP levels upon admission to the intensive care unit (ICU), the clinical course, and other related factors were evaluated.A total of 21 patients were examined. One-third of the patients presented with high EA levels at the time of ICU admission.However, there was no significant correlation between EA and I-FABP levels (Spearman r=0.002, P=.993). Additionally, high EA levels were not associated with abdominal complications after ICU admission or mortality. Similarly, high EA levels were not associated with severity scores, inotropic scores, or lactate levels upon ICU admission, which were previously reported to be factorsrelated to high EA levels.In this posthoc analysis, no correlation was observed between endotoxemia and enterocyte injury among patients in gram-positive septic shock. Additionally, high EA levels were not associated with the clinical course and reported factors related to endotoxemia.Although our results need to be validated in a large prospective cohort study, hypoperfusion enterocyte injury might not be a cause of endotoxemia in these patients. Thus, if there is no correlation between EA and I-FABP levels, other mechanisms that induce high EA levels among patients with gram-positive septic shock should be elucidated.
Keywords: endotoxin / endotoxin activity assay / hypoperfusion / intensive care unit / sepsis / intestinal ischemia
URI: http://hdl.handle.net/10069/39384
ISSN: 00257974 / 15365964
DOI: 10.1097/MD.0000000000016452
Rights: © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/39384

All items in NAOSITE are protected by copyright, with all rights reserved.

 

Valid XHTML 1.0! Copyright © 2006-2015 Nagasaki University Library - Feedback Powerd by DSpace