Intestinal failure: Pathophysiological elements and clinical diseases

Ding, Lian-An; Li, Jieshou

doi:10.3748/wjg.v10.i7.930

Cited by 10 publications

(6 citation statements)

References 24 publications

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“…In addition to the enhanced muscle breakdown (11), disturbed protein synthesis or breakdown in gut tissue could potentially play a role in the severity of the response to sepsis. It is known that gut atrophy causes gut dysfunction in sepsis (12). Gut dysfunction is responsible for increased translocation of bacteria from the gut into the bloodstream, and therefore, it contributes to the severity of the septic state.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of jejunal protein synthesis and breakdown in Pseudomonas aeruginosa-induced sepsis pig model

Have

Engelen

Wolfe

et al. 2019

American Journal of Physiology-Gastrointestinal and Liver Physi

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Maintenance of gut integrity has long been recognized as crucial for survival in sepsis, but alterations in protein metabolism have not previously been documented. Therefore, in the present study, we measured in a Pseudomonas aeruginosa-induced porcine sepsis model fractional protein synthesis (FSR) and breakdown rates (FBR) in jejunal mucosa in a fasted, conscious state. FSR was measured by the incorporation rate of stable tracer amino acid (l-[ ring-13C6]phenylalanine) into tissue protein. FBR was determined using the relation between blood arterial enrichment and intracellular enrichment of phenylalanine in consecutive mucosal biopsies after a pulse of l-[15N]phenylalanine. Additionally, we determined the FSR in jejunum, ileum, liver, muscle, and lung tissue. We found in this sham-controlled acute sepsis pig model (control: n = 9; sepsis: n = 13) that jejunal mucosal protein turnover is reduced with both decreased FSR (control: 3.29 ± 0.22; sepsis: 2.32 ± 0.12%/h, P = 0.0008) and FBR (control: 0.72 ± 0.12; sepsis: 0.34 ± 0.04%/h, P = 0.006). We also found that FSR was unchanged in ileum and muscle, whereas it was higher in the liver (control: 0.87 ± 0.05; sepsis: 1.05 ± 0.06%/h, P = 0.041). Our data, obtained with a translational acute sepsis model, suggest that jejunal mucosal protein metabolism is diminished in acute sepsis. Comparison with other tissues indicates that the most serious acute metabolic changes in sepsis occur in the jejunum rather than the muscle. NEW & NOTEWORTHY In a highly translational acute sepsis model, presented data suggest that jejunal mucosal protein metabolism is diminished in acute sepsis, even if the origin of the sepsis is not located in the gut. Comparison with other tissues indicates that the most serious acute changes in the protein synthesis rates in sepsis occur in the gut rather than the muscle. Therefore, we hypothesize that preventing a compromised gut is critical to maintain gut function during sepsis.

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Section: Introductionmentioning

confidence: 99%

Inhibition of jejunal protein synthesis and breakdown in Pseudomonas aeruginosa-induced sepsis pig model

Have

Engelen

Wolfe

et al. 2019

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…The intestinal barrier is effective in preventing the translocation of intestinal bacteria and its toxic products, and thus, it partly plays a role in the maintenance of the homeostasis of a body 6–9 . It is composed of a mechanical barrier created by the epithelium of intestinal mucosa, intestinal immunity, normal intestinal flora and chemical mucus barrier, functioning as a defense against the invasion of endogenous microorganisms 10–13 .…”

Section: Discussionmentioning

confidence: 99%

The preliminary experimental and clinical study of the relationship between the pigment gallstone and intestinal mucosal barrier

Yang

Fan

et al. 2009

J of Gastro and Hepatol

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“…Before the MODS and systemic inflammatory response syndrome (SIRS) were described in 1990s, Dr Metchnikoff suggested that the entrance of microbes and associated toxins from the bowel into the body was an important cause of early death. 6 Irving and colleagues were the first to describe the pathophysiology and clinical condition called “intestinal failure” in 1980s. 6 …”

Section: E Volution Of the C Oncept mentioning

confidence: 99%

“… 6 Irving and colleagues were the first to describe the pathophysiology and clinical condition called “intestinal failure” in 1980s. 6 …”

Section: E Volution Of the C Oncept mentioning

confidence: 99%

Acute Intestinal Failure

Chandankhede

Kulkarni

2020

Indian Journal of Critical Care Medicine

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A bstract Acute intestinal failure (AIF), “reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, requiring parenteral nutrition”, is common, but very often neglected part of multiorgan dysfunction syndrome (MODS) in the critically ill patients. It is now increasingly being recognized as a cause of prolonged ICU and hospital stay and poor outcome. Multidisciplinary team approach, systematic approach to management with treatment of sepsis, early mobilization and enteral feeding with prokinetics if required, control of intra-abdominal pressure and surgical intervention, when mandated, can help treat AIF and improve patient outcomes. How to cite this article: Chandankhede SR, Kulkarni AP. Acute Intestinal Failure. Indian J Crit Care Med 2020;24(Suppl 4):S168–S174.

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Intestinal failure: Pathophysiological elements and clinical diseases

Cited by 10 publications

References 24 publications

Inhibition of jejunal protein synthesis and breakdown in Pseudomonas aeruginosa-induced sepsis pig model

Inhibition of jejunal protein synthesis and breakdown in Pseudomonas aeruginosa-induced sepsis pig model

The preliminary experimental and clinical study of the relationship between the pigment gallstone and intestinal mucosal barrier

Acute Intestinal Failure

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