Evidence map›Paper›PMID 36527517›Full record

ArticleAnnals of intensive care2022

A multicentric prospective observational study of diagnosis and prognosis features in ICU mesenteric ischemia: the DIAGOMI study.

Simon Bourcier, Guillaume Ulmann, Matthieu Jamme, Guillaume Savary, Marine Paul, Sarah Benghanem, Jean-Rémi Lavillegrand, Matthieu Schmidt, Charles-Edouard Luyt, Eric Maury and 4 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.

  1. Pooled it
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  14. [Epidemiology and diagnostics of mesenteric ischemia].Chirurgie (Heidelberg, Germany) · 2024
    Review
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  16. Managing acute mesenteric ischaemia.Intensive care medicine · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Simon BourcierMedical Intensive Care Unit, AP-HP, Institut Cochin, Cochin Hospital, Centre & Université de Paris, INSERM U1016, CNRS UMR8104, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France. simon_bourcier@hotmail.com.ORCID http://orcid.org/0000-0003-4358-2330
Guillaume UlmannClinical Chemistry Department, AP-HP Centre, Hôpital Cochin, Université de Paris, Paris, France.
Matthieu JammeRéanimation Polyvalente, Hôpital Privé de l'Ouest Parisien, Ramsay Générale de Santé, Trappes, France.
Guillaume SavaryMedical Intensive Care Unit, AP-HP, Institut Cochin, Cochin Hospital, Centre & Université de Paris, INSERM U1016, CNRS UMR8104, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
Marine PaulMedical Intensive Care Unit, AP-HP, Institut Cochin, Cochin Hospital, Centre & Université de Paris, INSERM U1016, CNRS UMR8104, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
Sarah BenghanemMedical Intensive Care Unit, AP-HP, Institut Cochin, Cochin Hospital, Centre & Université de Paris, INSERM U1016, CNRS UMR8104, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
Jean-Rémi LavillegrandAP-HP, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Médecine Intensive Réanimation, Paris, France.
Matthieu SchmidtAssistance Publique-Hôpitaux de Paris, AP-HP, Médecine Intensive Réanimation, Pitié-Salpêtrière Hospital, Paris, France.
Charles-Edouard LuytAssistance Publique-Hôpitaux de Paris, AP-HP, Médecine Intensive Réanimation, Pitié-Salpêtrière Hospital, Paris, France.
Eric MauryAP-HP, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Médecine Intensive Réanimation, Paris, France.
Alain CombesAssistance Publique-Hôpitaux de Paris, AP-HP, Médecine Intensive Réanimation, Pitié-Salpêtrière Hospital, Paris, France.
Frédéric PèneMedical Intensive Care Unit, AP-HP, Institut Cochin, Cochin Hospital, Centre & Université de Paris, INSERM U1016, CNRS UMR8104, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
Nathalie NeveuxClinical Chemistry Department, AP-HP Centre, Hôpital Cochin, Université de Paris, Paris, France.
Alain CariouMedical Intensive Care Unit, AP-HP, Institut Cochin, Cochin Hospital, Centre & Université de Paris, INSERM U1016, CNRS UMR8104, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.
Centre National de la Recherche Scientifique · FRInserm · FRSorbonne Université · FRUniversité Paris Cité · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-occlusive mesenteric ischemia (NOMI) is a challenging diagnosis and is associated with extremely high mortality in critically ill patients, particularly due to delayed diagnosis and when complicated by intestinal necrosis. Plasma citrulline and intestinal-fatty acid binding protein (I-FABP) have been proposed as potential biomarkers, but have never been studied prospectively in this setting. We aimed to investigate diagnostic features, the accuracy of plasma citrulline and I-FABP to diagnose NOMI and intestinal necrosis as well as prognosis.

methodsWe conducted a prospective observational study in 3 tertiary ICU centers in consecutive patients with NOMI suspicion defined by at least two inclusion criteria among: new-onset or worsening circulatory failure, gastrointestinal dysfunction, biological signs and CT-scan signs of mesenteric ischemia. Diagnosis features and outcomes were compared according to NOMI, intestinal necrosis or ruled out diagnosis using stringent classification criteria.

resultsDiagnosis of NOMI was suspected in 61 patients and confirmed for 33 patients, with intestinal necrosis occurring in 27 patients. Clinical digestive signs, routine laboratory results and CT signs of mesenteric ischemia did not discriminate intestinal necrosis from ischemia without necrosis. Plasma I-FABP was significantly increased in presence of intestinal necrosis (AUC 0.83 [0.70-0.96]). A threshold of 3114 pg/mL showed a sensitivity of 70% [50-86], specificity of 85% [55-98], a negative predictive value of 58% [36-93] and a positive predictive value 90% [67-96] for intestinal necrosis diagnosis. When intestinal necrosis was present, surgical resection was significantly associated with ICU survival (38.5%), whereas no patient survived without necrosis resection (HR = 0.31 [0.12-0.75], p = 0.01).

conclusionIn critically ill patients with NOMI, intestinal necrosis was associated with extremely high mortality, and increased survival when necrosis resection was performed. Elevated plasma I-FABP was associated with the diagnosis of intestinal necrosis. Further studies are needed to investigate plasma I-FABP and citrulline performance in less severe forms of NOMI.

Indexed as

Critically illMesenteric ischemiaObservationalPlasma citrullinePlasma intestinal-fatty acid binding protein

Identifiers

PMID36527517
PMCPMC9759607
OpenAlexW4312064757

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.