Association between enterocyte injury and fluid balance in patients with septic shock: a post hoc exploratory analysis of a prospective observational study.
Association between enterocyte injury and fluid balance in patients with septic shock: a post hoc exploratory analysis of a prospective observational study.
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DOI：
10.1186/s12871-021-01515-2
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发表时间：
2021-11-23
影响因子：
2.2
通讯作者：
Hara T
中科院分区：
文献类型：
--
作者：
Yokoyama H;Sekino M;Funaoka H;Sato S;Araki H;Egashira T;Yano R;Matsumoto S;Ichinomiya T;Higashijima U;Hara T
感染性休克患者所需的液体量不同。休克引起的肠细胞损伤可能通过在肠缺血/坏死的情况下触发全身性炎症反应或缺血-再灌注损伤而增加对液体的需求。本研究旨在评价感染性休克患者肠上皮细胞损伤与液体正平衡之间的关系。本研究是一项前瞻性观察性研究的事后探索性分析，该研究评估了血清肠脂肪酸结合蛋白（肠细胞损伤的生物标志物）与脓毒性休克患者死亡率之间的相关性。在入住重症监护室时记录肠道脂肪酸结合蛋白水平，并从入住重症监护室至第7天监测液体平衡。评估入院时肠道脂肪酸结合蛋白水平与重症监护病房入院后早期输液平衡之间的关系。进行了多元线性回归分析，并对严重程度评分和肾功能进行了调整。共分析了57例患者的数据。对数转换的肠道脂肪酸结合蛋白水平与重症监护病房入院后24和72小时的累积液体平衡/体重显著相关，（Pearson's r = 0.490 [95%可信区间：0.263-0.666]; P < 0.001和r = 0.479 [95%可信区间：0.240-0.664]; P < 0.001）和校正严重程度评分和肾功能后（估计值分别为14.4 [95%置信区间：4.1-24.7]; P = 0.007和估计值分别为26.9 [95%置信区间：11.0-42.7]; P = 0.001）。肠上皮细胞损伤与重症监护病房入院后24和72小时的累积液体平衡显著相关。感染性休克患者的肠细胞损伤可能与重症监护病房入院后早期过度液体积聚有关。
The required fluid volume differs among patients with septic shock. Enterocyte injury caused by shock may increase the need for fluid by triggering a systematic inflammatory response or an ischemia-reperfusion injury in the presence of intestinal ischemia/necrosis. This study aimed to evaluate the association between enterocyte injury and positive fluid balance in patients with septic shock. This study was a post hoc exploratory analysis of a prospective observational study that assessed the association between serum intestinal fatty acid-binding protein, a biomarker of enterocyte injury, and mortality in patients with septic shock. Intestinal fatty acid-binding protein levels were recorded on intensive care unit admission, and fluid balance was monitored from intensive care unit admission to Day 7. The association between intestinal fatty acid-binding protein levels at admission and the infusion balance during the early period after intensive care unit admission was evaluated. Multiple linear regression analysis, with adjustments for severity score and renal function, was performed. Overall, data of 57 patients were analyzed. Logarithmically transformed intestinal fatty acid-binding protein levels were significantly associated with cumulative fluid balance per body weight at 24 and 72 h post-intensive care unit admission both before (Pearson’s r = 0.490 [95% confidence interval: 0.263–0.666]; P < 0.001 and r = 0.479 [95% confidence interval: 0.240–0.664]; P < 0.001, respectively) and after (estimate, 14.4 [95% confidence interval: 4.1–24.7]; P = 0.007 and estimate, 26.9 [95% confidence interval: 11.0–42.7]; P = 0.001, respectively) adjusting for severity score and renal function. Enterocyte injury was significantly associated with cumulative fluid balance at 24 and 72 h post-intensive care unit admission. Enterocyte injury in patients with septic shock may be related to excessive fluid accumulation during the early period after intensive care unit admission.
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DOI：
10.1186/s13054-015-0970-1
发表时间：
2015-06-15
期刊：
Critical care (London, England)
影响因子：
--
作者：
Acheampong A;Vincent JL
通讯作者：
Vincent JL
影响因子：
8.8
作者：
Piton, Gael;Belon, Francois;Capellier, Gilles
通讯作者：
Capellier, Gilles
影响因子：
2.7
作者：
Wang YM;Chen Y;Zheng YJ;Huang YC;Chen WW;Ji R;Xu LL;Yang ZT;Sheng HQ;Qu HP;Mao EQ;Chen EZ
通讯作者：
Chen EZ
影响因子：
2.8
作者：
Kitai T;Kim YH;Kiefer K;Morales R;Borowski AG;Grodin JL;Tang WHW
通讯作者：
Tang WHW
影响因子：
13.2
作者：
Matsuo, Seiichi;Imai, Enyu;Hishida, Akira
通讯作者：
Hishida, Akira