prognostic impact of fecal ph in critically ill patients危重患者的预后的影响粪便的ph值.pdfVIP

Osuka et al. Critical Care 2012, 16:R119 /content/16/4/R119 RESEARCH Open Access Prognostic impact of fecal pH in critically ill patients 1* 2 1 1 3 4 Akinori Osuka , Kentaro Shimizu , Hiroshi Ogura , Osamu Tasaki , Toshimitsu Hamasaki , Takashi Asahara , 4 4 1 1 Koji Nomoto , Masami Morotomi , Yasuyuki Kuwagata and Takeshi Shimazu Abstract Introduction: We have reported that altered gut flora is associated with septic complications and eventual death in critically ill patients with systemic inflammatory response syndrome. It is unclear how fecal pH affects these patients. We sought to determine whether fecal pH can be used as an assessment tool for the clinical course of critically ill patients. Methods: Four hundred ninety-one fecal samples were collected from 138 patients who were admitted to the Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Japan. These patients were treated in the intensive care unit for more than 2 days. Fecal pH, fecal organic acids, and fecal bacteria counts were measured and compared by survived group and nonsurvived group, or nonbacteremia group and bacteremia group. Logistic regression was used to estimate relations between fecal pH, age, sex, or APACHE II score and mortality, and incidence of bacteremia. Differences in fecal organic acids or fecal bacteria counts among acidic, neutral, and alkaline feces were analyzed. Results: The increase of fecal pH 6.6 was significantly associated with the increased mortality (odds ratio, 2.46; 95% confidence interval, 1.25 to 4.82) or incidence of bact