Chaignat Claire, Lagrost Laurent, Moretto Karena, de Barros Jean-Paul Pais, Winiszewski Hadrien, Grober Jacques, Saas Philippe, Piton Gaël
Medical Intensive Care Unit, Besançon University Hospital, Besançon, France.
INSERM, LNC UMR1231, LabEx LipSTIC, Dijon, France.
J Crit Care. 2024 Feb;79:154438. doi: 10.1016/j.jcrc.2023.154438. Epub 2023 Oct 3.
Gut can be a source of sepsis but sepsis itself can induce gut dysfunction. We aimed to study whether plasma citrulline, a marker of enterocyte mass, was correlated with plasma lipopolysaccharide, a potential marker of bacterial translocation among critically ill patients.
Critically ill patients admitted to the ICU. Plasma citrulline and plasma LPS concentration and activity were measured at ICU admission. Patients were compared according to the presence of sepsis at ICU admission.
109 critically ill patients, with SOFA score 8 [6-12], were prospectively included. Sixty six patients (61%) had sepsis at ICU admission. There was no correlation between plasma citrulline concentration and plasma LPS concentration or activity. However, sepsis at ICU admission was associated with a lower plasma citrulline concentration (13.4 μmol.L vs 21.3 μmol.L, p = 0.02). Plasma LPS activity was significantly higher among patients with abdominal sepsis compared to patients with extra-abdominal sepsis (1.04 EU/mL vs 0.63, p = 0.01).
Plasma citrulline is not associated with the level of plasma LPS but is strongly decreased among septic patients. Detection of LPS is ubiquitous among critically ill patients but abdominal sepsis is associated with increased plasma LPS activity compared to extra-abdominal sepsis.
肠道可能是脓毒症的一个来源，但脓毒症本身可诱发肠道功能障碍。我们旨在研究肠细胞质量标志物——血浆瓜氨酸，是否与危重症患者细菌移位的潜在标志物——血浆脂多糖相关。
入住重症监护病房（ICU）的危重症患者。在入住ICU时测定血浆瓜氨酸以及血浆脂多糖（LPS）的浓度和活性。根据入住ICU时是否存在脓毒症对患者进行比较。
前瞻性纳入109例危重症患者，序贯器官衰竭评估（SOFA）评分8[6 - 12]。66例患者（61%）入住ICU时存在脓毒症。血浆瓜氨酸浓度与血浆LPS浓度或活性之间无相关性。然而，入住ICU时的脓毒症与较低的血浆瓜氨酸浓度相关（13.4μmol/L对21.3μmol/L，p = 0.02）。与非腹部脓毒症患者相比，腹部脓毒症患者的血浆LPS活性显著更高（1.04 EU/mL对0.63，p = 0.01）。
血浆瓜氨酸与血浆LPS水平无关，但在脓毒症患者中显著降低。LPS检测在危重症患者中普遍存在，但与非腹部脓毒症相比，腹部脓毒症与血浆LPS活性增加相关。
