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Endotoxin Activity Assay for the Detection of Whole Blood Endotoxemia in Critically Ill Patients
Published on: June 24, 2019
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Anti-endotoxin antibodies consumption in cardiovascular collapse: Pathophysiological concerns
E Villarreal1, P Ramírez1, M Gordon1
1Critical Care Department, Hospital Universitario y Politécnico la Fe, Valencia, Spain.
Medicina Intensiva
|November 7, 2022
Summary
Endotoxin exposure is present in both septic shock and cardiogenic shock patients. However, endotoxin levels could not fully distinguish between these critical conditions in severely ill patients.
Area of Science:
- Critical care medicine
- Immunology
- Pathophysiology
Background:
- Abnormal endotoxin activity can occur in critically ill patients without Gram-negative bacterial infection.
- Disease severity is a key factor in detecting endotoxin exposure phenomena.
Purpose of the Study:
- To assess and compare endotoxin exposure in patients with septic shock (SS) and cardiogenic shock (CS).
- To evaluate the role of endotoxin exposure in differentiating between SS and CS.
Main Methods:
- Prospective, observational study of 62 critically ill patients (25 SS, 37 CS) over three days.
- Daily analysis of inflammatory biomarkers and IgM anti-endotoxin-core antibodies (IgM EndoCAb).
- Comparison of endotoxin exposure between SS and CS groups, and within SS based on infection type.
Main Results:
- EndoCAb consumption was higher in SS patients.
- 59.5% of CS patients had low IgM anti-endotoxin levels, suggesting endotoxin exposure.
- Endotoxin exposure showed moderate ability to distinguish between SS and CS (AUC 0.7892).
Conclusions:
- Severely ill patients may have mechanisms allowing endotoxin incursion, blurring disease pathophysiology.
- Endotoxin exposure alone is not fully capable of distinguishing between cardiogenic and septic shock.
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