TY - JOUR
T1 - Catecholamine use is associated with enterocyte damage in critically ill patients
AU - Piton, Gael
AU - Cypriani, Benoit
AU - Regnard, Jacques
AU - Patry, Cyrille
AU - Puyraveau, Marc
AU - Capellier, Gilles
PY - 2015
Y1 - 2015
N2 - Small bowel damage is frequent but underdiagnosed among critically ill patients with shock. High catecholamine
doses may have a deleterious effect on mesenteric blood flow. Plasma intestinal fatty acidYbinding protein (I-FABP)
concentration is a marker of enterocyte damage, whereas plasma citrulline concentration is a marker of functional
enterocyte mass. We hypothesized that high doses of catecholamines in critically ill patients may be associated with
enterocyte damage. This study aimed to determine the link between catecholamine use and dose with enterocyte damage.
This is a prospective observational study performed in a large regional university teaching hospital. Critically ill patients
requiring epinephrine and/or norepinephrine at admission to a medical intensive care unit (ICU) were included, as well as
controls not receiving catecholamines. We evaluated at admission plasma I-FABP and citrulline concentrations, abdominal
perfusion pressure (APP), and variables relating to prognosis and treatment. Patients were categorized according to the
quartiles of catecholamine dose at ICU admission. Sixty critically ill patients receiving catecholamines and 27 not receiving
catecholamines were included. Plasma I-FABP was higher among patients receiving catecholamine than in controls.
Among patients receiving catecholamines, a dose of 0.48 + kgj1 minj1 or more at ICU admission was associated with a
higher I-FABP concentration. A Sepsis-related Organ Failure Assessment score higher than 11 and plasma I-FABP more
than 524 pg mLj1 at ICU admission were independently associated with 28-day mortality (odds ratio, 4.0 [1.24Y12.95] and
odds ratio, 4.90 [1.44Y16.6], respectively). Catecholamine use is associated with I-FABP elevation in critically ill patients.
Critically ill patients receiving more than 0.48 + kgj1 minj1 of epinephrine and/or norepinephrine at ICU admission have
high I-FABP concentrations. This suggests that enterocyte damage reflects t
AB - Small bowel damage is frequent but underdiagnosed among critically ill patients with shock. High catecholamine
doses may have a deleterious effect on mesenteric blood flow. Plasma intestinal fatty acidYbinding protein (I-FABP)
concentration is a marker of enterocyte damage, whereas plasma citrulline concentration is a marker of functional
enterocyte mass. We hypothesized that high doses of catecholamines in critically ill patients may be associated with
enterocyte damage. This study aimed to determine the link between catecholamine use and dose with enterocyte damage.
This is a prospective observational study performed in a large regional university teaching hospital. Critically ill patients
requiring epinephrine and/or norepinephrine at admission to a medical intensive care unit (ICU) were included, as well as
controls not receiving catecholamines. We evaluated at admission plasma I-FABP and citrulline concentrations, abdominal
perfusion pressure (APP), and variables relating to prognosis and treatment. Patients were categorized according to the
quartiles of catecholamine dose at ICU admission. Sixty critically ill patients receiving catecholamines and 27 not receiving
catecholamines were included. Plasma I-FABP was higher among patients receiving catecholamine than in controls.
Among patients receiving catecholamines, a dose of 0.48 + kgj1 minj1 or more at ICU admission was associated with a
higher I-FABP concentration. A Sepsis-related Organ Failure Assessment score higher than 11 and plasma I-FABP more
than 524 pg mLj1 at ICU admission were independently associated with 28-day mortality (odds ratio, 4.0 [1.24Y12.95] and
odds ratio, 4.90 [1.44Y16.6], respectively). Catecholamine use is associated with I-FABP elevation in critically ill patients.
Critically ill patients receiving more than 0.48 + kgj1 minj1 of epinephrine and/or norepinephrine at ICU admission have
high I-FABP concentrations. This suggests that enterocyte damage reflects t
UR - http://www-scopus-com.ezproxy.lib.monash.edu.au/record/display.url?eid=2-s2.0-84928641525&origin=resultslist&sort=plf-f&src=s&st1=CATECHOLAMINE+USE+IS
U2 - 10.1097/SHK.0000000000000327
DO - 10.1097/SHK.0000000000000327
M3 - Article
SN - 1073-2322
VL - 43
SP - 437
EP - 442
JO - Shock
JF - Shock
IS - 5
ER -