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Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients

Objective: To investigate the early warning and prognostic evaluation of fecal calprotectin (FC), D-lactic acid, and bedside gastrointestinal ultrasound (B-GIUS) data for acute gastrointestinal injury (AGI) in sepsis patients. Main Method: Sepsis patients were grouped based on the presence or absenc...

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Autores principales: Li, Junlu, Ren, Yanbo, Gao, Chang, Zhang, Kaili, Zheng, Fuwen, Kang, Jian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757724/
https://www.ncbi.nlm.nih.gov/pubmed/35047957
http://dx.doi.org/10.3389/fmedt.2021.733940
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author Li, Junlu
Ren, Yanbo
Gao, Chang
Zhang, Kaili
Zheng, Fuwen
Kang, Jian
author_facet Li, Junlu
Ren, Yanbo
Gao, Chang
Zhang, Kaili
Zheng, Fuwen
Kang, Jian
author_sort Li, Junlu
collection PubMed
description Objective: To investigate the early warning and prognostic evaluation of fecal calprotectin (FC), D-lactic acid, and bedside gastrointestinal ultrasound (B-GIUS) data for acute gastrointestinal injury (AGI) in sepsis patients. Main Method: Sepsis patients were grouped based on the presence or absence of AGI into AGI and non-AGI groups. Healthy volunteers of the same period were selected as the control group. FC, B-GIUS data, D-lactic acid, etc. were collected on the 1st, 3rd and 7th days of admission. Twenty-eight-day mortality was recorded. Main Results: FC, D-lactic acid levels, gastric antrum cross-sectional area, and small intestine wall thickness were significantly increased in group A and B (P < 0.05); furthermore, inner-to-outer diameter ratio and cross-sectional area of small intestine were lower than those in the control group (P < 0.05). FC, D-lactic acid, gastric antrum cross-sectional area and small intestine wall thickness in AGI group were higher than those in non-AGI group (P < 0.05). Inner-to-outer diameter ratio and cross-sectional area of small intestine in AGI group were smaller than those in non-AGI group (P < 0.05). There was no difference in the thickness, inner-to-outer diameter ratio nor the cross-sectional area ratio of colon between AGI and non-AGI groups (P > 0.05). AUC for D-lactic acid was 0.881, which was higher than FC's (0.74). When the D-lactic acid cutoff value was 22.16 μmol/L, the sensitivity was 77.9% and the specificity was 92% for the prediction of AGI in sepsis. AUC for the cross-sectional area of the gastrointestinal antrum was 0.657, which was higher than the small intestine thickness's (0.629). When the gastric antrum cross-sectional area was larger than 4.20 cm(2), the sensitivity was 64% and the specificity was 65.3%. Conclusion: D-Lactic acid and FC were early diagnostic indicators for sepsis with AGI, and D-lactic acid was the superior indicator. The gastric antrum cross-sectional area and the small intestine wall thickness had an early warning effect, and the prediction of the gastric antrum cross-sectional area was superior to that of the latter. Because it is non-invasive and convenient, B-GIUS can help in the diagnosis of sepsis with AGI.
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spelling pubmed-87577242022-01-18 Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients Li, Junlu Ren, Yanbo Gao, Chang Zhang, Kaili Zheng, Fuwen Kang, Jian Front Med Technol Medical Technology Objective: To investigate the early warning and prognostic evaluation of fecal calprotectin (FC), D-lactic acid, and bedside gastrointestinal ultrasound (B-GIUS) data for acute gastrointestinal injury (AGI) in sepsis patients. Main Method: Sepsis patients were grouped based on the presence or absence of AGI into AGI and non-AGI groups. Healthy volunteers of the same period were selected as the control group. FC, B-GIUS data, D-lactic acid, etc. were collected on the 1st, 3rd and 7th days of admission. Twenty-eight-day mortality was recorded. Main Results: FC, D-lactic acid levels, gastric antrum cross-sectional area, and small intestine wall thickness were significantly increased in group A and B (P < 0.05); furthermore, inner-to-outer diameter ratio and cross-sectional area of small intestine were lower than those in the control group (P < 0.05). FC, D-lactic acid, gastric antrum cross-sectional area and small intestine wall thickness in AGI group were higher than those in non-AGI group (P < 0.05). Inner-to-outer diameter ratio and cross-sectional area of small intestine in AGI group were smaller than those in non-AGI group (P < 0.05). There was no difference in the thickness, inner-to-outer diameter ratio nor the cross-sectional area ratio of colon between AGI and non-AGI groups (P > 0.05). AUC for D-lactic acid was 0.881, which was higher than FC's (0.74). When the D-lactic acid cutoff value was 22.16 μmol/L, the sensitivity was 77.9% and the specificity was 92% for the prediction of AGI in sepsis. AUC for the cross-sectional area of the gastrointestinal antrum was 0.657, which was higher than the small intestine thickness's (0.629). When the gastric antrum cross-sectional area was larger than 4.20 cm(2), the sensitivity was 64% and the specificity was 65.3%. Conclusion: D-Lactic acid and FC were early diagnostic indicators for sepsis with AGI, and D-lactic acid was the superior indicator. The gastric antrum cross-sectional area and the small intestine wall thickness had an early warning effect, and the prediction of the gastric antrum cross-sectional area was superior to that of the latter. Because it is non-invasive and convenient, B-GIUS can help in the diagnosis of sepsis with AGI. Frontiers Media S.A. 2021-11-01 /pmc/articles/PMC8757724/ /pubmed/35047957 http://dx.doi.org/10.3389/fmedt.2021.733940 Text en Copyright © 2021 Li, Ren, Gao, Zhang, Zheng and Kang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medical Technology
Li, Junlu
Ren, Yanbo
Gao, Chang
Zhang, Kaili
Zheng, Fuwen
Kang, Jian
Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients
title Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients
title_full Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients
title_fullStr Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients
title_full_unstemmed Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients
title_short Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients
title_sort evaluation of fecal calprotectin, d-lactic acid and bedside gastrointestinal ultrasound image data for the prediction of acute gastrointestinal injury in sepsis patients
topic Medical Technology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8757724/
https://www.ncbi.nlm.nih.gov/pubmed/35047957
http://dx.doi.org/10.3389/fmedt.2021.733940
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