Endotoxin Mass Concentration in Plasma Is Associated With Mortality in a Multicentric Cohort of Peritonitis-Induced Shock.

Fiche publication

Date publication

janvier 2021

Journal

Frontiers in medicine

Auteurs

Membres identifiés du Cancéropôle Est :
Dr LAGROST Laurent , Dr PAIS DE BARROS Jean-Paul

Tous les auteurs :
Payen D, Dupuis C, Deckert V, Pais de Barros JP, Rérole AL, Lukaszewicz AC, Coudroy R, Robert R, Lagrost L

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/34778311

Résumé

To investigate the association of plasma LPS mass with mortality and inflammation in patients with peritonitis-induced septic shock (SS). Longitudinal endotoxin and inflammatory parameters in a multicentric cohort of SS. Protocolized post-operative parameters of 187 SS patients collected at T1 (12 h max post-surgery) and T4 (24 h after T1). analysis of ABDOMIX trial. Plasma concentration of LPS mass as determined by HPLC-MS/MS analysis of 3-hydroxymyristate, activity of phospholipid transfer protein (PLTP), lipids, lipoproteins, IL-6, and IL-10. Cohort was divided in low (LLPS) and high (HLPS) LPS levels. The predictive value for mortality was tested by multivariate analysis. HLPS and LLPS had similar SAPSII (58 [48.5; 67]) and SOFA (8 [6.5; 9]), but HLPS showed higher death and LPS to PLTP ratio ( < 0.01). LPS was stable in HLPS, but it increased in LLPS with a greater decrease in IL-6 ( < 0.01). Dead patients had a higher T1 LPS ( = 0.02), IL-6 (<0.01), IL-10 (=0.01), and day 3 SOFA score ( = 0.01) than survivors. In the group of SAPSII > median, the risk of death in HLPS (38%) was higher than in LLPS (24%; < 0.01). The 28-day death was associated only with SAPSII (OR 1.06 [1.02; 1.09]) and HLPS (OR 2.47 [1; 6.11]) in the multivariate model. In HLPS group, high PLTP was associated with lower plasma levels of IL-6 ( = 0.02) and IL-10 ( = 0.05). Combination of high LPS mass concentration and high SAPS II is associated with elevated mortality in peritonitis-induced SS patients.