Diagnostic and prognostic implications of endotoxemia in critical illness: results of the MEDIC study

The Journal of Infectious Diseases
John C MarshallMEDIC study

Abstract

A novel assay for endotoxin, based on the ability of antigen-antibody complexes to prime neutrophils for an augmented respiratory burst response, was studied in a cohort study of 857 patients admitted to an intensive-care unit (ICU). On the day of ICU admission, 57.2% of patients had either intermediate (>or=0.40 endotoxin activity [EA] units) or high (>or=0.60 units) EA levels. Gram-negative infection was present in 1.4% of patients with low EA levels, 4.9% with intermediate levels, and 6.9% with high levels; EA had a sensitivity of 85.3% and a specificity of 44.0% for the diagnosis of gram-negative infection. Rates of severe sepsis were 4.9%, 9.2%, and 13.2%, and ICU mortality was 10.9%, 13.2%, and 16.8% for patients with low, intermediate, and high EA levels, respectively. Stepwise logistic regression analysis showed that elevated Acute Physiology and Chronic Health Evaluation II score, gram-negative infection, and emergency admission status were independent predictors of EA.

Citations

Jun 28, 2008·Langenbeck's Archives of Surgery·Jean-Louis Vincent
Jun 29, 2010·Langenbeck's Archives of Surgery·Klaus ButtenschoenHendrik Bracht
Aug 29, 2006·Current Infectious Disease Reports·John C Marshall
Jul 7, 2011·Hepatology International·Yukihiro SanadaYoshikazu Yasuda
Jun 12, 2013·Immunology Letters·Ioannis KritselisEvangelos J Giamarellos-Bourboulis
Sep 25, 2009·Nature Reviews. Nephrology·Jean-Louis Vincent
Oct 21, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·John C Marshall
Oct 11, 2012·Surgical Infections·Tom van der Poll
Jan 29, 2013·Tissue Engineering. Part B, Reviews·Ramona LiederÓlafur Eysteinn Sigurjónsson
Nov 16, 2004·Critical Care Medicine·Jonathan CohenJames Jorgensen
Jun 3, 2009·Critical Care Medicine·John C MarshallUNKNOWN International Sepsis Forum
Aug 8, 2009·Critical Care Medicine·Mark TidswellUNKNOWN Eritoran Sepsis Study Group
Oct 5, 2012·Clinical Microbiology Reviews·Konrad ReinhartChristiane S Hartog
Oct 22, 2005·American Journal of Respiratory and Critical Care Medicine·Jean-Louis Vincent, Edward Abraham
Aug 27, 2011·American Journal of Respiratory and Critical Care Medicine·Nazima PathanJane A Mitchell
Dec 14, 2011·American Journal of Respiratory and Critical Care Medicine·Steven M Opal
Jun 25, 2008·Blood·John C Marshall
Mar 19, 2013·BMC Infectious Diseases·Peter Olupot-OlupotKathryn Maitland
May 11, 2013·Cardiovascular Diabetology·Zhong-Wei YangFu-Ming Shen
Mar 21, 2013·Journal of Inflammation·Michail YaroustovskyNickolay Krotenko
Feb 25, 2011·Critical Care : the Official Journal of the Critical Care Forum·David J KleinC David Mazer
Jun 10, 2011·Critical Care : the Official Journal of the Critical Care Forum·Shamik DholakiaSimon Nadel
Jan 25, 2012·Critical Care : the Official Journal of the Critical Care Forum·Peter PickkersJohannes G van der Hoeven
Aug 9, 2012·Critical Care : the Official Journal of the Critical Care Forum·James C HurleyEric Maury
Sep 13, 2013·Critical Care : the Official Journal of the Critical Care Forum·Alexander KochKai Zacharowski
Sep 26, 2006·Critical Care : the Official Journal of the Critical Care Forum·D Shane O'MahonyGustavo Matute-Bello
Apr 24, 2007·Critical Care : the Official Journal of the Critical Care Forum·Dinna N CruzClaudio Ronco
Jun 15, 2007·Critical Care : the Official Journal of the Critical Care Forum·John A Kellum
Jul 1, 2009·Critical Care : the Official Journal of the Critical Care Forum·Franco ValenzaLuciano Gattinoni
Oct 12, 2010·Critical Care : the Official Journal of the Critical Care Forum·Beatrice HaimovichStephen F Lowry
Dec 30, 2009·Annals of Surgical Oncology·Peter M NearyHenry P Redmond
Oct 26, 2005·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Emanuel P RiversKandis K Rivers
Mar 1, 2006·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Maja SurbatovićSonja Radaković
Jun 10, 2011·Indian Journal of Nephrology·P MalleshappaA B Shah
Mar 7, 2014·Cell and Tissue Research·Holger C Müller-RedetzkyMartin Witzenrath
Jul 22, 2014·Critical Care : the Official Journal of the Critical Care Forum·Claudio Ronco, David J Klein
Dec 30, 2014·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Hoi Ping ShumWing Wa Yan
Dec 5, 2012·Critical Care : the Official Journal of the Critical Care Forum·Alexander D RomaschinJohn C Marshall
Jan 5, 2010·Wiener klinische Wochenschrift·Bettina LeberVanessa Stadlbauer
Sep 9, 2011·Current Opinion in Critical Care·W Joost Wiersinga
Apr 5, 2011·Journal of Zhejiang University. Science. B·Jian-ping GaoQiu-ping Xu
Jun 27, 2013·Journal of Hepato-biliary-pancreatic Sciences·Mari SatoItaru Endo

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