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Payen D, Dupuis C, Deckert V, Pais de Barros JP, Rérole AL, Lukaszewicz AC, Coudroy R, Robert R, Lagrost L. Endotoxin Mass Concentration in Plasma Is Associated With Mortality in a Multicentric Cohort of Peritonitis-Induced Shock. Front Med (Lausanne) 2021; 8:749405. [PMID: 34778311 PMCID: PMC8586519 DOI: 10.3389/fmed.2021.749405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/06/2021] [Indexed: 01/22/2023] Open
Abstract
Objectives: To investigate the association of plasma LPS mass with mortality and inflammation in patients with peritonitis-induced septic shock (SS). Design: Longitudinal endotoxin and inflammatory parameters in a multicentric cohort of SS. Patients: Protocolized post-operative parameters of 187 SS patients collected at T1 (12 h max post-surgery) and T4 (24 h after T1). Intervention: Post-hoc analysis of ABDOMIX trial. Measurements and Results: 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 (p < 0.01). LPS was stable in HLPS, but it increased in LLPS with a greater decrease in IL-6 (p < 0.01). Dead patients had a higher T1 LPS (p = 0.02), IL-6 (<0.01), IL-10 (=0.01), and day 3 SOFA score (p = 0.01) than survivors. In the group of SAPSII > median, the risk of death in HLPS (38%) was higher than in LLPS (24%; p < 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 (p = 0.02) and IL-10 (p = 0.05). Conclusions: Combination of high LPS mass concentration and high SAPS II is associated with elevated mortality in peritonitis-induced SS patients.
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Affiliation(s)
- Didier Payen
- UFR de Médecine Lariboisière-Saint-Louis, University Paris 7 Denis Diderot, Paris, France
| | - Claire Dupuis
- Medical Intensive Care Unit, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Valérie Deckert
- Inserm, LNC-UMR1231, Dijon, France.,University Bourgogne-Franche Comté, LNC-UMR1231, Dijon, France.,LabEx LipSTIC, FCS Bourgogne-France Comté, Dijon, France
| | - Jean-Paul Pais de Barros
- Inserm, LNC-UMR1231, Dijon, France.,University Bourgogne-Franche Comté, LNC-UMR1231, Dijon, France.,LabEx LipSTIC, FCS Bourgogne-France Comté, Dijon, France
| | - Anne-Laure Rérole
- Inserm, LNC-UMR1231, Dijon, France.,University Bourgogne-Franche Comté, LNC-UMR1231, Dijon, France.,LabEx LipSTIC, FCS Bourgogne-France Comté, Dijon, France.,CHU Dijon, Service de la Recherche, Dijon, France
| | | | - Remi Coudroy
- Department of Medical Intensive Care, La Miléterie University Hospital, Poitiers University, Poitiers, France
| | - René Robert
- Department of Medical Intensive Care, La Miléterie University Hospital, Poitiers University, Poitiers, France
| | - Laurent Lagrost
- Inserm, LNC-UMR1231, Dijon, France.,University Bourgogne-Franche Comté, LNC-UMR1231, Dijon, France.,LabEx LipSTIC, FCS Bourgogne-France Comté, Dijon, France.,CHU Dijon, Service de la Recherche, Dijon, France
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