Endotoxemia in critically ill patients: why a reliable test could be beneficial
AUTOR(ES)
Balk, Robert A
FONTE
BioMed Central
RESUMO
The detection of endotoxemia may provide a clue to the cause of sepsis or may indicate translocation of endotoxin from the gastrointestinal tract. A reliable endotoxin activity assay (EAA) offers the potential to determine Gram-negative infections in critically ill patients. In addition, a reliable EAA may indicate the adequacy of gastrointestinal tract perfusion, as well as potentially help to predict morbidity and mortality. A recent study by Marshall and colleagues, published in the present issue of Critical Care, evaluated the use of a whole blood EAA in a medical–surgical intensive care unit and found that 58% of the patients had positive endotoxin assays. However, only 13.5% of the population had a documented Gram-negative infection. This discrepancy and the observation that translocation and other causes of endotoxemia may not reflect true Gram-negative infection might severely limit the clinical utility of this EAA. Further study may better define the potential role of this technique in the diagnostic evaluation of the critically ill patient.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=137306Documentos Relacionados
- B-type natriuretic levels in critically ill patients: critically misleading?
- Accidental catheter removal in critically ill patients: a prospective and observational study
- Hypomagnesemia in critically ill cancer patients: a prospective study of predictive factors
- Characteristics of chronically critically ill patients: comparing two definitions
- Prevention and diagnosis of venous thromboembolism in critically ill patients: a Canadian survey