Document Detail


Plasma citrulline is a marker of absorptive small bowel length in patients with transient enterostomy and acute intestinal failure.
MedLine Citation:
PMID:  19744750     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Small bowel disruption is often complicated by acute intestinal failure and can be corrected by chyme reinfusion (CR). Plasma citrulline ([Cit]) is a biomarker of the enterocyte mass. Our aim was to determine whether [Cit] could be a marker of absorptive intestinal mass or function by assessing whether CR could affect intestinal absorptive function and [Cit]. METHODS: Twenty-six patients with small bowel disruption and double enterostomy were treated with CR. Fecal wet weight, nitrogen and fat absorption, parenteral nutrition delivery and [Cit] were measured before and after the initiation of CR with a median follow-up of 30 days. RESULTS: CR decreased the intestinal wet weight output (median+/-IQ, 2384+/-969 vs. 216+/-242mLd(-1), P<0.0001) and parenteral nutrition dependence (65% vs. 8%, P<0.01). CR was associated with a rise in net nitrogen and fat digestive absorption and [Cit] (17.0+/-10.0 vs. 31.0+/-12.0micromolL(-1), P=0.0001). Before the initiation of CR, [Cit] correlated positively with the absorptive post-duodenal small bowel length (r=0.39, P=0.04), but not with the total post-duodenal small bowel length (r=0.11, P=0.60). CONCLUSION: CR allows for a dramatic improvement of intestinal absorptive function and a near doubling in [Cit] level. [Cit] is not a marker of overall intestinal mass, but of the absorptive small bowel function.
Authors:
Denis Picot; Laurence Garin; Florence Trivin; Michel P Kossovsky; Dominique Darmaun; Ronan Thibault
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2009-09-09
Journal Detail:
Title:  Clinical nutrition (Edinburgh, Scotland)     Volume:  29     ISSN:  1532-1983     ISO Abbreviation:  Clin Nutr     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-07-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309603     Medline TA:  Clin Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  235-42     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Affiliation:
Service de R?adaptation Digestive et Nutritionnelle, Clinique Saint Yves, 4 rue Adolphe Leray CS54435, Rennes F-35044, France. picot@clinique-styves.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Aged
Biological Markers / blood
Body Mass Index
Citrulline / blood*
Enteral Nutrition / methods
Enterocytes / physiology*
Enterostomy*
Female
Gastrointestinal Contents
Humans
Intestinal Absorption / physiology*
Intestinal Diseases / blood*,  physiopathology*,  surgery
Intestine, Small / physiopathology*
Male
Middle Aged
Nutritional Status
Severity of Illness Index
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 372-75-8/Citrulline

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