Procalcitonin and intestinal ischemia: A review of the literature

Cossé, Cyril; Sabbagh, Charles; Kamel, Saı̈d; Galmiche, Antoine; Régimbeau, Jean‐Marc

doi:10.3748/wjg.v20.i47.17773

Cited by 39 publications

(25 citation statements)

References 45 publications

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“…Procalcitonin may have some value in distinguishing bacterial infections from other sources of inflammation,8081828399 but the data are not sufficient to recommend the routine use of procalcitonin in the diagnosis of secondary peritonitis or in the identification of patients with bowel compromise. Similarly, C reactive protein may have a role in predicting the need for surgery in patients with abdominal pain,100101 or in identifying post-operative patients who develop a septic complication,102103104105 but the data are insufficient to recommend routine clinical use.…”

Section: Laboratory Measuresmentioning

confidence: 99%

Secondary peritonitis: principles of diagnosis and intervention

Ross

Matthay

Harris

2018

BMJ

102

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Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis.

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Section: Laboratory Measuresmentioning

confidence: 99%

Secondary peritonitis: principles of diagnosis and intervention

Ross

Matthay

Harris

2018

BMJ

102

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“…This precursor of the calcitonin is currently used in clinical practice for the differential diagnosis of infection of bacterial origin. According to a systematic review by Cosse et al [49], PCT's positive and negative predictive values for the diagnosis of acute i3 ranged between 27% and 90% and between 81% and 100%, respectively. As underlined by the authors, PCT is usually elevated during sepsis, in specific bacterial infections, and in various types of ischemias.…”

Section: Biomarker Of Infectionmentioning

confidence: 99%

Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

Peoc’h

Nuzzo

Guedj

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Acute intestinal ischemic injury (i3) is a lifethreatening condition with disastrous prognosis, which is currently difficult to diagnose at the early stages of the disease; a rapid diagnosis is mandatory to avoid irreversible ischemia, extensive bowel resection, sepsis and death. The overlapping protein expression of liver and gut related to the complex physiopathology of the disease, the heterogeneity of the disease and its relative rarity could explain the lack of a useful early biochemical marker of i3. Apart from non-specific biological markers of thrombosis, hypoxia inflammation, and infection, several more specific biomarkers in relation with the gut barrier dysfunction, the villi injury and the enterocyte mass have been used in the diagnosis of acute i3. It includes particularly D-lactate, intestinal fatty acid-binding protein (FABP) and citrulline. Herein, we will discuss leading publications concerning these historical markers that point out the main limitations reagrding their use in routine clinical practice. We will also introduce the first and limited results arising from omic studies, underlying the remaining effort that needs to be done in the field of acute i3 biological diagnosis, which remains a challenge.

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“…При бактериемии его концентрация может возрастать в сотни раз. Однако именно вследствие этого он не может быть высокоспецифичным для ОИИ, что находит подтверждение в литературе [23,24,25].…”

Section: биохимические маркеры острой интестинальной ишемииunclassified

New Biomarkers of Acute Mesenteric Ischemia

Чернооков¹,

Bozhedomov²,

Atayan³

et al. 2018

Novosti Khirurgii

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СОВРЕМЕННЫЕ БИОМАРКЕРЫ ОСТРОЙ ИНТЕСТИНАЛЬНОЙ ИШЕМИИПервыйОстрая интестинальная ишемия является одной из наиболее сложных проблем в ургентной хирургии в силу высокой летальности, одной из причин которой является поздняя диагностика. Оперативное лече-ние часто проводится в фазу разлитого перитонита.С целью выделения наиболее доступных и точных способов ранней диагностики острой интести-нальной ишемии выполнен данный обзор литературы.В настоящее время для диагностики острой интестинальной ишемии используют немногочислен-ный ряд биомаркеров, таких как α-глутамат-S-трансфераза, D-димеры, прокальцитонин, D-лактат, кишеч-ный белок, связывающий жирные кислоты (I-FABP), ишемия-модифицированный альбумин. По данным литературы, наиболее высокие показатели чувствительности и специфичности выявлены у I-FABP (75-85% и 70-80% соответственно), α-глутамат-S-трансферазы (67,8% и 84,2%), ишемия-модифицированного альбумина (94,7% и 86,4%). Кроме этого, для ранней диагностики в настоящее время используются до-рогостоящие и инвазивные методы, такие как КТ-ангиография, МРТ с контрастированием, селективная ангиография, однако данные технологии доступны не всем лечебным учреждениям.Для решения проблемы улучшения ранней диагностики острой интестинальной ишемии следует про-водить дальнейший поиск различных биомаркеров и их более широкое внедрение в клиническую практику. Ключевые слова: острая интестинальная ишемия, биомаркеры, диагностика, мезентериальный тромбоз, кишечный белок, связывающий жирные кислоты (I-FABP)The acute mesenteric ischemia is one of the most complex problems in the urgent surgery because of the high mortality, the cause of which is late diagnosis. The operation treatment is often provided in the phase of diffuse peritonitis.This literature review is done in order to identify the most accessible and accurate methods of early diagnosis of the acute mesenteric ischemia.At present time rather a small number of biomarkers for diagnosing the acute mesenteric ischemia are used, such as α-glutamate-S-transferase, D-dimers, procalcitonin, D-lactate, intestinal fatty acid binding protein (I-FABP), ischemia-modified albumin. According to the literature the highest sensitivity and specificity were found in I-FABP (75-85% and 70-80% respectively), α-glutamate-S-transferase (67.8% and 84.2%), ischemia-modified albumin (94.7% and 86.4%). In addition, expensive and invasive methods are currently used for early diagnosis, such as CT angiography, contrast-enhanced MRI, selective angiography. However, these technologies are not available to all medical institutions.We should continue further search of various biomarkers and their more widespread introduction to clinical practice in order to solve the problem of early acute mesenteric ischemia diagnostics.

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Procalcitonin and intestinal ischemia: A review of the literature

Cited by 39 publications

References 45 publications

Secondary peritonitis: principles of diagnosis and intervention

Secondary peritonitis: principles of diagnosis and intervention

Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

New Biomarkers of Acute Mesenteric Ischemia

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