| Increased colorectal permeability in patients with severe sepsis and septic shock. | |
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MedLine Citation:
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PMID: 16964483 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To develop a method for the assessment of colorectal permeability in septic patients. DESIGN AND SETTING: Observational study in ICUs at two university hospitals. PARTICIPANTS: Nine patients with septic shock and abdominal focus of infection, 7 with severe sepsis and pulmonary focus and 8 healthy subjects. MEASUREMENTS AND RESULTS: Colorectal permeability was assessed as the initial appearance rate of (99m)Tc-DTPA in plasma after instillation into the rectal lumen and as the cumulative systemic recovery at 1h. To calculate the latter, volume of distribution and renal clearance of (99m)Tc-DTPA was estimated by an i.v. bolus of (51)Cr-EDTA. The initial rate of permeability was increased in patients with septic shock and severe sepsis compared with controls [29.0 (3.7-83.3), 20.6 (3.6-65.5) and 6.0 (2.2-9.6)cpm ml(-1)min(-1), respectively, p<0.05)] with a positive linear trend (r (2)=0.27, p=0.01) and correlated to L-lactate concentrations in the rectal lumen (r (2)=0.39, p<0.05). The cumulative permeability was also increased in patients with septic shock and severe sepsis compared with controls [2.07 (0.05-15.7), 0.32 (0.01-1.2) and 0.03 (0.01-0.06) per thousand, respectively, p<0.01] and correlated to the initial permeability rate (r (2)=0.26, p=0.01). CONCLUSIONS: In septic patients, the systemic recovery of a luminally applied marker of paracellular permeability was increased and related to the luminal concentrations of L-lactate and possibly to disease severity. This suggests that the assessment of colorectal permeability by systemic recovery of (99m)Tc-DTPA is valid and that metabolic dysfunction of the mucosa contributes to increased permeability of the large bowel in patients with severe sepsis and septic shock. |
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Authors:
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Vibeke L Jørgensen; Steen L Nielsen; Kurt Espersen; Anders Perner |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2006-09-09 |
Journal Detail:
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Title: Intensive care medicine Volume: 32 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2006 Nov |
Date Detail:
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Created Date: 2006-10-20 Completed Date: 2007-02-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1790-6 Citation Subset: IM |
Affiliation:
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Department of Anaesthesia and Intensive Care, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Case-Control Studies Female Humans Intestinal Mucosa / metabolism* Intestine, Large / metabolism* Lactic Acid / metabolism Male Middle Aged Permeability Sepsis / physiopathology* Shock, Septic / physiopathology* Technetium Tc 99m Pentetate / diagnostic use |
| Chemical | |
Reg. No./Substance:
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50-21-5/Lactic Acid; 65454-61-7/Technetium Tc 99m Pentetate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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