Enterocyte Damage in Critically Ill Patients Is Associated With Shock Condition and 28-Day Mortality*

Piton, Gaël; Belon, François; Cypriani, Benoit; Regnard, Jacques; Puyraveau, Marc; Manzon, C.; Navellou, Jean-Christophe; Capellier, Gilles

doi:10.1097/ccm.0b013e31828c26b5

Cited by 102 publications

(67 citation statements)

References 23 publications

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“…Surprisingly, we were not able to confirm results from other literature, which found that elevated iFABP correlates with both greater enterocyte damage and elevated lactate levels (12,13). Although MAP and Hb are independently associated with increased iFABP levels (13), these parameters cannot explain any differences as they did not vary between the trauma groups.…”

Section: Discussioncontrasting

confidence: 99%

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Induced Hypothermia Preserves the Functional Enterocyte Mass in A Porcine Multiple Trauma Model

Fröhlich¹,

Maegele²,

Hildebrand³

et al. 2016

SHOCK

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Section: Discussioncontrasting

confidence: 99%

“…Plasma citrulline and Òintestinal Fatty Acid Binding ProteinÓ (iFABP) have been suggested as reliable biomarkers for assessing gut injury (8)(9)(10)(11)(12)(13)(14). Citrulline is an amino acid synthesized in small bowel enterocytes from glutamine and is constantly released to the blood (8).…”

Section: Introductionmentioning

confidence: 99%

Induced Hypothermia Preserves the Functional Enterocyte Mass in A Porcine Multiple Trauma Model

Fröhlich¹,

Maegele²,

Hildebrand³

et al. 2016

SHOCK

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show abstract

“…Citrulline is an amino acid mainly synthesized by small bowel enterocyte, and the concentration of plasma citrulline has previously been recognized as a marker of functional enterocyte mass in small bowel diseases (7)(8)(9). In addition, low plasma citrulline concentrations in critically ill patients are associated with a high mortality rate (10,11). Intestinal fatty acid-binding protein (I-FABP), a protein specifically localized in small bowel enterocytes, is released in plasma in case of enterocyte damage (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Enterocyte Damage

Piton

Belin

Barrot

et al. 2015

Shock

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Cardiac arrest is considered to be a cause of small bowel ischemia, but the consequences of cardiac arrest on the human small bowel have been rarely studied. Plasma citrulline concentration is a marker of functional enterocyte mass, and plasma intestinal fatty acid-binding protein (I-FABP) concentration is a marker of enterocyte damage. We aimed to measure enterocyte biomarkers after cardiac arrest and to study the prognostic value of biomarker abnormalities. This is a prospective, observational, single-center study of patients admitted to the intensive care unit (ICU) for cardiac arrest, evaluating plasma citrulline and I-FABP concentrations at admission and after 24 h and variables according to the Utstein criteria. Variables according to 28-day Cerebral Performance Category score of 1 to 2 (good neurological outcome) versus 3 to 5 (poor neurological outcome) were compared. Sixty-nine patients with cardiac arrest of both cardiac and hypoxic origin were included. At ICU admission, plasma citrulline concentration was low in 65% and plasma I-FABP was elevated in 82% of the patients. After 24 h, plasma citrulline was low in 82% and I-FABP was normal in 60% of the patients. Patients with a poor neurological outcome had a lower plasma citrulline concentration and a higher I-FABP concentration at ICU admission. By multivariate analysis, plasma citrulline levels of 13.1 μmol L or less and I-FABP more than 260 pg mL were independently associated with a poor neurological outcome (odds ratio, 21.9 [2.2-215], and odds ratio, 13.6 [1.4-129], respectively). Cardiac arrest resuscitation is associated with evidence of small bowel mucosal damage in most patients, with a short and intense I-FABP elevation at admission and a decrease in citrulline concentration during the first day. In this study, low plasma citrulline and high I-FABP concentrations at ICU admission were predictive of a poor neurological outcome. This study confirms that cardiac arrest is a model of small bowel mucosal ischemia and suggests that enterocyte damage is a piece in the puzzle of post-cardiac arrest syndrome.

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“…Previous studies on citrulline have focused only on diseases such as short bowel syndrome [5], viral enteritis [4], intestinal transplants [6], intestinal toxicity due to chemotherapy [7], and Crohn's disease [8]. More recently, there have been a few studies that have focused on critically ill patients [9,10]. Crenn et al showed that plasma citrulline levels decreased, and were lower when digestive bacterial translocation occurred at the onset of septic shock.…”

Section: Introductionmentioning

confidence: 99%

Serum citrulline as a diagnostic marker of sepsis-induced intestinal dysfunction

Shen

Guan

et al. 2015

Clinics and Research in Hepatology and Gastroenterology

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Enterocyte Damage in Critically Ill Patients Is Associated With Shock Condition and 28-Day Mortality*

Abstract: In critically ill patients, enterocyte damage is frequent, and it is significantly associated with shock and 28-day mortality. The link between intestinal fatty acid-binding protein and plasma citrulline concentrations in critically ill patients needs to be further evaluated.

Cited by 102 publications

References 23 publications

Induced Hypothermia Preserves the Functional Enterocyte Mass in A Porcine Multiple Trauma Model

Induced Hypothermia Preserves the Functional Enterocyte Mass in A Porcine Multiple Trauma Model

Enterocyte Damage

Serum citrulline as a diagnostic marker of sepsis-induced intestinal dysfunction

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