Table 1 Digestive, biological parameters and CT results among patients with defined and ruled out intestinal necrosis
Characteristics | Gastrointestinal failure (n = 54) | Ruled out necrosis (n = 13) | Definite necrosis (n = 27) | P value* |
|---|---|---|---|---|
Digestive manifestation criteria | 47 (87.0) | 12 (92.3) | 23 (85.2) | 1 |
Upper digestive hemorrhage | 4 (7.4) | 1 (7.7) | 2 (7.4) | 1 |
Vomiting or gastric residual** | 23 (42.6) | 6 (46.2) | 12 (44.4) | 1 |
Lower digestive hemorrhage | 15 (27.8) | 7 (53.8) | 8 (29.6) | 0.17 |
Diarrhea | 31 (55.6) | 8 (61.5) | 13 (48.1) | 0.51 |
Abdominal pain | 22 (40.7) | 3 (23.1) | 10 (37.0) | 0.48 |
Abdominal distension | 17 (31.5) | 2 (15.4) | 13 (48.1) | 0.08 |
Worst 24 h prior inclusion biological findings | ||||
Leukocyte count (G/L) | 16.6 [9.8–24.9] | 10.3 [8.3–19.2] | 20.1 [10.0–26.4] | 0.16 |
Platelets (G/L) | 107 [56–228] | 124 [73–214] | 78 [44–107] | 0.09 |
Arterial lactate, mmol/L | 5.2 [3.0–8.3] | 4.0 [2.8–7.9] | 6.6 [3.9–12.9] | 0.05 |
Arterial pH | 7.32 [7.24–7.43] | 7.40 [7.29–7.47] | 7.31 [7.13–7.38] | 0.02 |
Bicarbonates, mmol/L | 18.9 [13.6–21.5] | 20.5 [19.1–23.2] | 14.5 [12.2–19.4] | 0.01 |
Potassium, mmol/L | 4.6 [3.9–5.3] | 4.3 [3.6–5.0] | 5.0 [4.5–5.4] | 0.09 |
Aspartate transaminase (IU/L) | 175 [65–819] | 66 [43–196] | 358 [105–1731] | 0.02 |
Alanine transaminase (IU/L) | 123 [50–549] | 55 [37–115] | 346 [109–778] | 0.01 |
Bilirubin (µmol/L) | 34 [13–123] | 21 [16–61] | 65 [22–162] | 0.14 |
LDH (IU/L) | 757 [436–2366] | 510 [367–784] | 1822 [779–4150] | 0.003 |
CPK (IU/L) | 770 [149–2543] | 359 [105–974] | 1794 [864–8683] | 0.01 |
Procalcitonin (µg/L) | 6.4 [2.0–15.5] | 0.7 [0.4–4.0] | 11.9 [5.7–24.0] | 0.005 |
Positive blood culture | 14 (25.9) | 2 (15.4) | 8 (29.6) | 0.45 |
Candidemia | 4 (7.4) | 0 (0.0) | 3 (11.1) | 0.54 |
Specific biomarkers | ||||
Plasma I-FABP (pg/mL) | 2976 [1143–9493] | 1137 [639–2130] | 6925 [2100–29686] | 0.001 |
Plasma citrulline (µmol/mL) | 20 [13–29] | 28 [15–42] | 19 [16–29] | 0.61 |
Plasma arginine (µmol/mL) | 43 [29–63] | 53 [39–64] | 43 [29–73] | 0.38 |
Plasma citrulline/arginine ratio | 0.46 [0.27–0.68] | 0.44 [0.25–0.69] | 0.47 [0.36–0.63] | 0.46 |
CT conclusion | ||||
Not done | 9 (16.7) | 0 (0.0) | 7 (25.9) | 0.08 |
No sign of mesenteric ischemia | 29 (53.7) | 11 (84.6) | 6 (22.2) | < 0.001 |
Mesenteric ischemia | 16 (29.6) | 2 (15.4) | 14 (51.9) | < 0.001 |
CT findings | ||||
Abnormal wall enhancement | 14 (31.1) | 2 (15.4) | 11 (55.0) | 0.03 |
Pneumatosis intestinalis | 4 (8.9) | 0 (0.0) | 4 (20.0) | 0.14 |
Bowel dilation | 16 (35.6) | 3 (23.1) | 11 (55.0) | 0.09 |
Portal venous gas | 2 (4.4) | 0 (0.0) | 2 (10.0) | 0.51 |
Atherosclerosis of mesenteric arteries | 13 (29.5) | 4 (30.8) | 6 (30.0) | 1 |