Purpose To measure the prevalence of elevated Endotoxin Activity (EA) in a large cohort of patients with Septic Shock (SS), and to assess its value as an early indicator of Gram-Negative (GN) infection, disease severity, and patient risk. Materials and methods Adult patients were enrolled in this observational study if an EA determination was obtained within 24-h from SS onset. Demographic, clinical, and microbiological data were collected. In-hospital follow-up was also conducted. Results A high prevalence of endotoxemia was observed in the 107 subjects included, with 82% of patients showing either intermediate (≥ 0.4 units), or high (≥ 0.6) EA. Patients with positive cultures for GNs showed a higher mean EA (0.63 ± 0.18 vs. 0.53 ± 0.22; p < 0.05). However, the test showed poor accuracy in the identification of GN bacteria as SS causative agents. Significantly higher lactate concentration (p = 0.006), SOFA (p = 0.04) and inotropic score (p = 0.006) were observed in patients with endotoxemia. However, higher EA levels neither influenced mortality, nor length of stay. Conclusions Early after SS onset, patients showed a high prevalence of endotoxemia, particularly those infected with GN bacteria. The EA assay might be a useful marker of disease severity. The complexity of such patients, however, limits EA accuracy in identifying GN sepsis and predicting outcome.
Bottiroli, M., Monti, G., Pinciroli, R., Vecchi, I., Terzi, V., Ortisi, G., et al. (2017). Prevalence and clinical significance of early high Endotoxin Activity in septic shock: An observational study. JOURNAL OF CRITICAL CARE, 41, 124-129 [10.1016/j.jcrc.2017.04.030].
|Citazione:||Bottiroli, M., Monti, G., Pinciroli, R., Vecchi, I., Terzi, V., Ortisi, G., et al. (2017). Prevalence and clinical significance of early high Endotoxin Activity in septic shock: An observational study. JOURNAL OF CRITICAL CARE, 41, 124-129 [10.1016/j.jcrc.2017.04.030].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Prevalence and clinical significance of early high Endotoxin Activity in septic shock: An observational study|
|Autori:||Bottiroli, M; Monti, G; Pinciroli, R; Vecchi, I; Terzi, V; Ortisi, G; Casella, G; Fumagalli, R|
PINCIROLI, RICCARDO (Corresponding)
FUMAGALLI, ROBERTO (Ultimo)
|Data di pubblicazione:||2017|
|Rivista:||JOURNAL OF CRITICAL CARE|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.jcrc.2017.04.030|
|Appare nelle tipologie:||01 - Articolo su rivista|