Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Endotoxemia in critically ill patients: why a reliable test could be beneficial. | Available online http content 6 4 289 Commentary Endotoxemia in critically ill patients why a reliable test could be beneficial Robert A Balk Director Section of Pulmonary Critical Care Medicine Rush Medical College and Rush-Presbyterian-St Luke s Medical Center and Voluntary Attending Cook County Hospital Chicago Illinois USA Correspondence Robert A Balk rbalk@ Published online 20 June 2002 Critical Care 2002 6 289-290 This article is online at http content 6 4 289 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract The detection of endotoxemia may provide a clue to the cause of sepsis or may indicate translocation of endotoxin from the gastrointestinal tract. A reliable endotoxin activity assay EAA offers the potential to determine Gram-negative infections in critically ill patients. In addition a reliable EAA may indicate the adequacy of gastrointestinal tract perfusion as well as potentially help to predict morbidity and mortality. A recent study by Marshall and colleagues published in the present issue of Critical Care evaluated the use of a whole blood EAA in a medical-surgical intensive care unit and found that 58 of the patients had positive endotoxin assays. However only of the population had a documented Gram-negative infection. This discrepancy and the observation that translocation and other causes of endotoxemia may not reflect true Gram-negative infection might severely limit the clinical utility of this EAA. Further study may better define the potential role of this technique in the diagnostic evaluation of the critically ill patient. Keywords endotoxemia Gram-negative infection prognosis sepsis translocation In the present issue of Critical Care John Marshall and colleagues report on a clinical trial designed to evaluate the use of an EAA in patients admitted to a medical-surgical intensive care unit 1 . Endotoxin plays a central role in sepsis 2 3 . The current gold standard for the .
