ArticleCritical care medicine2016
Endotoxemia Following Multiple Trauma: Risk Factors and Prognostic Implications.
Article in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 38 citations in OpenAlex.
- Intestinal Permeability Is Associated with Mortality and Readmission in Children Hospitalized with Severe Acute Malnutrition.The Journal of nutrition · 2026Observational
- Nanotechnology-mediated strategies for skeletal muscle repair and regeneration: targeted intervention, functional remodeling, and translational challenges.Journal of nanobiotechnology · 2026Review
- Core sociodemographic data variables reported in Canadian intensive care unit studies: a scoping review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Review
- Negative Factors Influencing Multiple-Trauma Patients.Clinics and practice · 2024Article
- Gaps and opportunities in sepsis translational research.EBioMedicine · 2022Review
- Endotoxin removal therapy with Polymyxin B immobilized fiber column as a COVID-19-bedside strategy protocol for endotoxic shock.Frontiers in nephrology · 2022Article
- Prominent Indomethacin-Induced Enteropathy in FcgriibInternational journal of molecular sciences · 2021Article
- Endothelial heterogeneity across distinct vascular beds during homeostasis and inflammation.eLife · 2020Article
- Risk Factors of Bacteremia following Multiple Traumas.Emergency medicine international · 2020Article
- Reduced Proprotein convertase subtilisin/kexin 9 (PCSK9) function increases lipoteichoic acid clearance and improves outcomes in Gram positive septic shock patients.Scientific reports · 2019Article
- Observational
- Children With Noncritical Infections Have Increased Intestinal Permeability, Endotoxemia and Altered Innate Immune Responses.The Pediatric infectious disease journal · 2019Article
- Comparative Evaluation of Endotoxin Activity Level and Various Biomarkers for Infection and Outcome of ICU-Admitted Patients.Biomedicines · 2019Article
- Comparison of the source and prognostic utility of cfDNA in trauma and sepsis.Intensive care medicine experimental · 2019Article
- Innate immune responses to trauma.Nature immunology · 2018Review
- S100A8/A9 and sRAGE kinetic after polytrauma; an explorative observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Observational
- Polytrauma Defined by the New Berlin Definition: A Validation Test Based on Propensity-Score Matching Approach.International journal of environmental research and public health · 2017Article
- Interleukin-37 suppresses the inflammatory response to protect cardiac function in old endotoxemic mice.Cytokine · 2017Article
- Klotho suppresses the inflammatory responses and ameliorates cardiac dysfunction in aging endotoxemic mice.Oncotarget · 2017Article
- Déjà-vu from the nineties: is there a perspective for anti-endotoxin strategies to improve the outcome of multiple trauma patients?Journal of thoracic disease · 2016Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo evaluate the prevalence and time course of systemic endotoxemia following severe multiple trauma, to define its risk factors, and to explore the correlation between post-trauma endotoxemia and organ dysfunction.
designProspective single-center cohort study.
settingEmergency department and ICU of adult tertiary care level I trauma center. PATIENTS: Forty-eight severely injured (Injury Severity Score ≥ 16) patients, admitted to ICU within 24 hours of injury.
interventionsNone. MEASUREMENTS AND MAIN
resultsEndotoxemia was not evident on initial presentation, but developed subsequently in 75% of patients, even in the absence of Gram-negative infection. Nonsurviving patients had higher endotoxin levels than survivors on day 1 (endotoxemia, 0.48 vs 0.28; p = 0.048). Shock at admission, or surgery within the first 48 hours after trauma, was associated with higher endotoxin levels and predicted subsequent maximal endotoxemia, after adjusting for other significant covariates. Maximal endotoxemia levels were higher in patients who developed organ dysfunction, reflected in a cumulative Multiple Organ Dysfunction Score greater than 25, and patients with an intermediate endotoxemia level (≥ 0.4) had more cardiovascular dysfunction.
conclusionsIt is the first study to detect increasing levels of endotoxemia following multiple trauma. Shock and early surgery predict the development of endotoxemia; endotoxemia is particularly associated with cardiovascular dysfunction. However, Gram-negative infections are uncommon in these patients, suggesting that the gastrointestinal tract is the dominant reservoir of endotoxin. Endotoxin may be an appropriate therapeutic target in patients who have sustained severe multiple trauma.
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