Prevalence of endotoxemia after surgery and its association with ICU length of stay

Franco Valenza, Lorella Fagnani, Silvia Coppola, Sara Froio, Francesca Sacconi, Cecilia Tedesco, Micol Maffioletti, Marta Pizzocri, Valentina Salice, Maria Luisa Ranzi, Cristina Marenghi, Luciano Gattinoni

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Abstract

Introduction: The aim of this observational study was to investigate the prevalence of endotoxemia after surgery and its association with ICU length of stay. Methods: 102 patients admitted to a university ICU after surgery were recruited. Within four hours of admission, functional data were collected and APACHE II severity score calculated. Arterial blood samples were taken and endotoxemia was measured by chemiluminescence (Endotoxin Activity (EA)). Patients were stratified according to their endotoxin levels (low, intermediate and high) and according to their surgical procedures. Differences between endotoxin levels were assessed by ANOVA, accepting P <0.05 as significant. Data are expressed as mean ± SD. Results: EA levels were low in 68 (66%) patients, intermediate in 17 (17%) and high in 17 (17%). Age (61 ± 17 years) and APACHE II score 8.3 ± 3.7 (P = 0.542) were not significantly different in the three EA groups. Functional parameters on admission were similar between EA groups: white blood cells 11093 ± 4605 cells/mm3 (P = 0.385), heart rate 76 ± 16 bpm (P = 0.898), mean arterial pressure 88.8 ± 13.6 mmHg (P = 0.576), lactate 1.18 ± 0.77 mmol/L (P = 0.370), PaO2/FiO2 383 ± 109 mmHg (P = 0.474). Patients with high levels of EA were characterized by longer length of stay in the ICU: 1.9 ± 3.0 days in the low EA group, 1.8 ± 1.4 days in intermediate and 5.2 ± 7.8 days in high group (P = 0.038). Conclusions: 17% of our patients were characterized by high levels of endotoxemia as assessed by EA assay, despite their low level of complexity on admission. High levels of endotoxin were associated with a longer ICU length of stay.

Original languageEnglish
Article numberR102
JournalCritical Care
Volume13
Issue number3
DOIs
Publication statusPublished - Jun 29 2009

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Endotoxemia
Endotoxins
Length of Stay
APACHE
Luminescence
Observational Studies
Lactic Acid
Analysis of Variance
Arterial Pressure
Leukocytes
Heart Rate

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

Valenza, F., Fagnani, L., Coppola, S., Froio, S., Sacconi, F., Tedesco, C., ... Gattinoni, L. (2009). Prevalence of endotoxemia after surgery and its association with ICU length of stay. Critical Care, 13(3), [R102]. https://doi.org/10.1186/cc7934

Prevalence of endotoxemia after surgery and its association with ICU length of stay. / Valenza, Franco; Fagnani, Lorella; Coppola, Silvia; Froio, Sara; Sacconi, Francesca; Tedesco, Cecilia; Maffioletti, Micol; Pizzocri, Marta; Salice, Valentina; Ranzi, Maria Luisa; Marenghi, Cristina; Gattinoni, Luciano.

In: Critical Care, Vol. 13, No. 3, R102, 29.06.2009.

Research output: Contribution to journalArticle

Valenza, F, Fagnani, L, Coppola, S, Froio, S, Sacconi, F, Tedesco, C, Maffioletti, M, Pizzocri, M, Salice, V, Ranzi, ML, Marenghi, C & Gattinoni, L 2009, 'Prevalence of endotoxemia after surgery and its association with ICU length of stay', Critical Care, vol. 13, no. 3, R102. https://doi.org/10.1186/cc7934
Valenza F, Fagnani L, Coppola S, Froio S, Sacconi F, Tedesco C et al. Prevalence of endotoxemia after surgery and its association with ICU length of stay. Critical Care. 2009 Jun 29;13(3). R102. https://doi.org/10.1186/cc7934
Valenza, Franco ; Fagnani, Lorella ; Coppola, Silvia ; Froio, Sara ; Sacconi, Francesca ; Tedesco, Cecilia ; Maffioletti, Micol ; Pizzocri, Marta ; Salice, Valentina ; Ranzi, Maria Luisa ; Marenghi, Cristina ; Gattinoni, Luciano. / Prevalence of endotoxemia after surgery and its association with ICU length of stay. In: Critical Care. 2009 ; Vol. 13, No. 3.
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abstract = "Introduction: The aim of this observational study was to investigate the prevalence of endotoxemia after surgery and its association with ICU length of stay. Methods: 102 patients admitted to a university ICU after surgery were recruited. Within four hours of admission, functional data were collected and APACHE II severity score calculated. Arterial blood samples were taken and endotoxemia was measured by chemiluminescence (Endotoxin Activity (EA)). Patients were stratified according to their endotoxin levels (low, intermediate and high) and according to their surgical procedures. Differences between endotoxin levels were assessed by ANOVA, accepting P <0.05 as significant. Data are expressed as mean ± SD. Results: EA levels were low in 68 (66{\%}) patients, intermediate in 17 (17{\%}) and high in 17 (17{\%}). Age (61 ± 17 years) and APACHE II score 8.3 ± 3.7 (P = 0.542) were not significantly different in the three EA groups. Functional parameters on admission were similar between EA groups: white blood cells 11093 ± 4605 cells/mm3 (P = 0.385), heart rate 76 ± 16 bpm (P = 0.898), mean arterial pressure 88.8 ± 13.6 mmHg (P = 0.576), lactate 1.18 ± 0.77 mmol/L (P = 0.370), PaO2/FiO2 383 ± 109 mmHg (P = 0.474). Patients with high levels of EA were characterized by longer length of stay in the ICU: 1.9 ± 3.0 days in the low EA group, 1.8 ± 1.4 days in intermediate and 5.2 ± 7.8 days in high group (P = 0.038). Conclusions: 17{\%} of our patients were characterized by high levels of endotoxemia as assessed by EA assay, despite their low level of complexity on admission. High levels of endotoxin were associated with a longer ICU length of stay.",
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AU - Valenza, Franco

AU - Fagnani, Lorella

AU - Coppola, Silvia

AU - Froio, Sara

AU - Sacconi, Francesca

AU - Tedesco, Cecilia

AU - Maffioletti, Micol

AU - Pizzocri, Marta

AU - Salice, Valentina

AU - Ranzi, Maria Luisa

AU - Marenghi, Cristina

AU - Gattinoni, Luciano

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N2 - Introduction: The aim of this observational study was to investigate the prevalence of endotoxemia after surgery and its association with ICU length of stay. Methods: 102 patients admitted to a university ICU after surgery were recruited. Within four hours of admission, functional data were collected and APACHE II severity score calculated. Arterial blood samples were taken and endotoxemia was measured by chemiluminescence (Endotoxin Activity (EA)). Patients were stratified according to their endotoxin levels (low, intermediate and high) and according to their surgical procedures. Differences between endotoxin levels were assessed by ANOVA, accepting P <0.05 as significant. Data are expressed as mean ± SD. Results: EA levels were low in 68 (66%) patients, intermediate in 17 (17%) and high in 17 (17%). Age (61 ± 17 years) and APACHE II score 8.3 ± 3.7 (P = 0.542) were not significantly different in the three EA groups. Functional parameters on admission were similar between EA groups: white blood cells 11093 ± 4605 cells/mm3 (P = 0.385), heart rate 76 ± 16 bpm (P = 0.898), mean arterial pressure 88.8 ± 13.6 mmHg (P = 0.576), lactate 1.18 ± 0.77 mmol/L (P = 0.370), PaO2/FiO2 383 ± 109 mmHg (P = 0.474). Patients with high levels of EA were characterized by longer length of stay in the ICU: 1.9 ± 3.0 days in the low EA group, 1.8 ± 1.4 days in intermediate and 5.2 ± 7.8 days in high group (P = 0.038). Conclusions: 17% of our patients were characterized by high levels of endotoxemia as assessed by EA assay, despite their low level of complexity on admission. High levels of endotoxin were associated with a longer ICU length of stay.

AB - Introduction: The aim of this observational study was to investigate the prevalence of endotoxemia after surgery and its association with ICU length of stay. Methods: 102 patients admitted to a university ICU after surgery were recruited. Within four hours of admission, functional data were collected and APACHE II severity score calculated. Arterial blood samples were taken and endotoxemia was measured by chemiluminescence (Endotoxin Activity (EA)). Patients were stratified according to their endotoxin levels (low, intermediate and high) and according to their surgical procedures. Differences between endotoxin levels were assessed by ANOVA, accepting P <0.05 as significant. Data are expressed as mean ± SD. Results: EA levels were low in 68 (66%) patients, intermediate in 17 (17%) and high in 17 (17%). Age (61 ± 17 years) and APACHE II score 8.3 ± 3.7 (P = 0.542) were not significantly different in the three EA groups. Functional parameters on admission were similar between EA groups: white blood cells 11093 ± 4605 cells/mm3 (P = 0.385), heart rate 76 ± 16 bpm (P = 0.898), mean arterial pressure 88.8 ± 13.6 mmHg (P = 0.576), lactate 1.18 ± 0.77 mmol/L (P = 0.370), PaO2/FiO2 383 ± 109 mmHg (P = 0.474). Patients with high levels of EA were characterized by longer length of stay in the ICU: 1.9 ± 3.0 days in the low EA group, 1.8 ± 1.4 days in intermediate and 5.2 ± 7.8 days in high group (P = 0.038). Conclusions: 17% of our patients were characterized by high levels of endotoxemia as assessed by EA assay, despite their low level of complexity on admission. High levels of endotoxin were associated with a longer ICU length of stay.

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