Severity of Illness in Intra-abdominal Infection

Skau, Tommy; Nyström, Per‐Olof; Carlsson, Christer

doi:10.1001/archsurg.1985.01390260022004

Cited by 56 publications

(22 citation statements)

References 20 publications

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“…2 Abbreviations used: AA, amino acids; a-vDO 2 , arteriovenous O 2 concentration difference; ␤-Ala, ␤-alanine; BCAA, branched-chain amino acids; CI, cardiac index; Group Pre-Sep-A: presepsis patients receiving a standard mixed AA solution, before randomization to Group Sep-A; Group Pre-Sep-B: presepsis patients receiving the same AA solution, before randomization to Group Sep-B; Group Sep-A, septic patients continued on the same AA solution; Group Sep-B, septic patients receiving a 49% BCAA-enriched AA solution; Hyp, hydroxyproline; MODS, multiple organ dysfunction syndrome; Pea, phosphoethanolamine; RI, respiratory index; Sep, sepsis; Tau, taurine; TPN, total parenteral nutrition. (Hume 1966), mortality rate (12.5 vs. 25%), age (25 Ϯ 6 vs. 32 Ϯ 19 y) and sex distribution, injury severity score (a widely used anatomic trauma severity index: medians 31 vs. 30, ranges from 14 to 48 and from 11 to 54, respectively) (Greenspan et al 1985) and sepsis severity score (medians 30 vs. 28, ranges from 9 to 54 and from 11 to 51, respectively) (Skau et al 1985, Stevens 1983. Group Sep-A included eight patients (3 women, 5 men) after motor vehicle accidents (n ϭ 6) or gunshot wounds (n ϭ 2), with combinations of severe abdominal, chest and head injuries.…”

Section: Methodsmentioning

confidence: 99%

The Relationship between Plasma Taurine and Other Amino Acid Levels in Human Sepsis

Chiarla¹,

Giovannini²,

Siegel³

et al. 2000

The Journal of Nutrition

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Although reports of decreased plasma taurine in trauma, sepsis and critical illness are available, very little is known about the relationships among changes in plasma taurine, other amino acid levels and metabolic variables. We analyzed a large series of plasma amino acid profiles obtained in trauma patients with sepsis who were undergoing total parenteral nutrition. The correlations between plasma taurine, other amino acid levels, parenteral substrate doses and metabolic and cardiorespiratory variables were assessed by regression analysis. Post-traumatic hypotaurinemia was followed by partial recovery toward less abnormal values when sepsis developed. Levels of taurine were directly and significantly related to levels of glutamate, aspartate, ␤-alanine and phosphoethanolamine (and unrelated to other amino acids). Levels of these amino acids increased simultaneously with increasing doses of leucine, isoleucine and valine in total parenteral nutrition. Decreasing taurine was associated with increasing lactate, arteriovenous O 2 concentration difference and respiratory index, and with decreasing cholesterol and cardiac index. These results characterize the relationships between plasma taurine and other amino acid levels in sepsis, provide evidence of amino acid interactions that may support taurine availability and show more severe decreases in plasma taurine with the worsening of metabolic and cardiorespiratory patterns.

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Section: Methodsmentioning

confidence: 99%

The Relationship between Plasma Taurine and Other Amino Acid Levels in Human Sepsis

Chiarla¹,

Giovannini²,

Siegel³

et al. 2000

The Journal of Nutrition

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“…†From Rangel-Frausto et al 31 ‡From Skau et al 33 § Not significant (Wilcoxon test for matched pairs). One patient in each group had endocarditis complicated by meningitis.…”

Section: Outcomementioning

confidence: 99%

Impact of Methicillin Resistance on the Outcome of Patients With Bacteremia Caused by Staphylococcus aureus

Harbarth¹,

Rutschmann²,

Sudre³

et al. 1998

Arch Intern Med

245

157

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“…Peritonitis is a frequent and life-threatening disease [1]. During the last century, however, great progress has been made in the management of this condition [2].…”

Section: Introductionmentioning

confidence: 99%

Are there Patients with Peritonitis Who Require Empiric Therapy for Enterococcus?

Harbarth

Uçkay

2004

European Journal of Clinical Microbiology & Infectious Dise

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Enterococci are an increasingly important cause of nosocomial infections. While the clinical impact of enterococci in cases of bacteremia and super-infections in selected patient populations has been well-established, their role as primary pathogens in polymicrobial intraabdominal infections remains controversial. While it has been suggested that the presence of enterococci increases the rate of infectious post-operative complication, it has also been demonstrated that polymicrobial intra-abdominal infections involving enterococci can be treated successfully with appropriate surgical drainage and antibiotics, such as cephalosporins, that are not active against enterococci. Therefore, the question arises of whether or not antibiotic coverage against enterococci should be included in the empirical treatment of peritonitis in certain high-risk patient populations. An extensive literature review revealed some evidence arguing in favour of using empirical therapy with enterococcal coverage for intra-abdominal infections in the following cases: (i) immunocompromised patients with nosocomial, post-operative peritonitis; (ii) patients with severe sepsis of abdominal origin who have previously received cephalosporins and other broad-spectrum antibiotics selecting for Enterococcus spp.; (iii) patients with peritonitis and valvular heart disease or prosthetic intravascular material, which place them at high risk of endocarditis. The ideal therapeutic regimen for these high-risk patients remains to be determined, but empirical therapy directed against enterococci should be considered.

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Severity of Illness in Intra-abdominal Infection

Cited by 56 publications

References 20 publications

The Relationship between Plasma Taurine and Other Amino Acid Levels in Human Sepsis

The Relationship between Plasma Taurine and Other Amino Acid Levels in Human Sepsis

Impact of Methicillin Resistance on the Outcome of Patients With Bacteremia Caused by Staphylococcus aureus

Are there Patients with Peritonitis Who Require Empiric Therapy for Enterococcus?

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