Abstract
In a recent issue of Critical Care, Poole and colleagues found that plasma citrulline concentration and glucose absorption were reduced in 20 critically ill patients compared with 15 controls; however, the authors found no correlation between these two variables. This study highlights the question of the accuracy of plasma citrulline for assessing small bowel function in critically ill patients. Future studies should take into account the type of intestinal failure considered, the particular metabolism of citrulline, the time of plasma citrulline measurement, as well as the range of citrullinemia considered.
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Poole A, Deane A, Summers M, Fletcher J, Chapman M. The relationship between fasting plasma citrulline concentration and small intestinal function in the critically ill. Crit Care. 2015;19:16.
Khadaroo RG, Marshall JC. Gastrointestinal dysfunction in the critically ill: can we measure it? Crit Care. 2008;12:180.
Deitch EA. Multiple organ failure. Pathophysiology and potential future therapy. Ann Surg. 1992;216:117–34.
Curis E, Nicolis I, Moinard C, Osowska S, Zerrouk N, Bénazeth S, et al. Almost all about citrulline in mammals. Amino Acids. 2005;29:177–205.
Crenn P, Coudray-Lucas C, Thuillier F, Cynober L, Messing B. Postabsorptive plasma citrulline concentration is a marker of absorptive enterocyte mass and intestinal failure in humans. Gastroenterology. 2000;119:1496–505.
Crenn P, Vahedi K, Lavergne-Slove A, Cynober L, Matuchansky C, Messing B. Plasma citrulline: a marker of enterocyte mass in villous atrophy-associated small bowel disease. Gastroenterology. 2003;124:1210–9.
Piton G, Manzon C, Cypriani B, Carbonnel F, Capellier G. Acute intestinal failure in critically ill patients: is plasma citrulline the right marker? Intensive Care Med. 2011;37:911–7.
Piton G, Manzon C, Monnet E, Cypriani B, Barbot O, Navellou J-C, et al. Plasma citrulline kinetics and prognostic value in critically ill patients. Intensive Care Med. 2010;36:702–6.
Piton G, Belon F, Cypriani B, Regnard J, Puyraveau M, Manzon C, et al. Enterocyte damage in critically ill patients is associated with shock condition and 28-day mortality. Crit Care Med. 2013;41:2169–76.
Crenn P, Neveux N, Chevret S, Jaffray P, Cynober L, Melchior J-C, et al. Plasma L-citrulline concentrations and its relationship with inflammation at the onset of septic shock: a pilot study. J Crit Care. 2014;29:e1–6.
Grimaldi D, Guivarch E, Neveux N, Fichet J, Pène F, Marx J-S, et al. Markers of intestinal injury are associated with endotoxemia in successfully resuscitated patients. Resuscitation. 2013;84:60–5.
Pan L, Wang X, Li W, Li N, Li J. The intestinal fatty acid binding protein diagnosing gut dysfunction in acute pancreatitis: a pilot study. Pancreas. 2010;39:633–8.
Noordally SO, Sohawon S, Semlali H, Michely D, Devriendt J, Gottignies P. Is there a correlation between circulating levels of citrulline and intestinal dysfunction in the critically ill? Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr. 2012;27:527–32.
Cynober L. Citrulline: just a biomarker or a conditionally essential amino acid and a pharmaconutrient in critically ill patients? Crit Care. 2013;17:122.
Coste J, Pouchot J. A grey zone for quantitative diagnostic and screening tests. Int J Epidemiol. 2003;32:304–13.
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See related research by Poole et al., http://ccforum.com/content/19/1/16
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Piton, G., Capellier, G. Plasma citrulline in the critically ill: intriguing biomarker, cautious interpretation. Crit Care 19, 204 (2015). https://doi.org/10.1186/s13054-015-0881-1
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DOI: https://doi.org/10.1186/s13054-015-0881-1