Endocrine Responses in Critically Ill Trauma Patients: Nuclear Emergency

Weissella strains are currently being used for biotechnological and probiotic purposes [1]. While, Weissella hellenica found in flounder intestine had probiotic effects [2], certain species from this genus are opportunistic pathogens in humans. Apart from being implicated in disease in farmed rainbow trout [3], Weissella has been found to cause the following disease in humans.1. endocarditis [4,5]2. bacteraemia [6]3. prosthetic joint infection [7]Whole genome sequences ‘find several virulence determinants such as collagen adhesins, aggregation sub- stances, mucus-binding proteins, and hemolysins in some species’, as well as antibiotic resistance-encoding genes [8]. Caution is warranted in selecting of Weissella strains as starter cultures or probiotics, if at all, since the other option, Lactobacillus, are rarely involved in human disease.Here, the analysis of the lung microbiota in critically ill trauma patients suffering from acute respiratory distress syndrome [9] shows (Accid:ERR1992912) shows complete colonization of Weissella (Fig 1). While, the study mentions ‘significant enrichment of potential pathogens including Streptococcus, Fusobacterium, Prevotella, Haemophilus and Treponema’, there is no reference to the Weissella genus. The percentages of Weissella strains are :confusa=81, soli=7 ,hellenica=5 ,diestrammenae=2. I believe this is the first reported case of Weissella causing ARDS in humans.

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Magnesium Infusion for Pain Management in Critically Ill Trauma Patients

Case Medical Research ◽

10.31525/ct1-nct04166877 ◽

2019 ◽

Author(s):

Keyword(s):

Pain Management ◽

Critically Ill ◽

Trauma Patients

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Algorithm for assessing renal dysfunction risk in critically ill trauma patients receiving aminoglycosides

The American Journal of Surgery ◽

10.1016/s0002-9610(05)81007-4 ◽

1990 ◽

Vol 160 (5) ◽

pp. 473-480 ◽

Cited By ~ 15

Author(s):

Bradley A. Boucher ◽

Bridgett C. Coffey ◽

David A. Kuhl ◽

Elizabeth A. Tolley ◽

Timothy C. Fabian

Keyword(s):

Renal Dysfunction ◽

Critically Ill ◽

Trauma Patients

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Hypomagnesemia as a Predictor of Mortality in Critically Ill Trauma Patients

Critical Issues in Surgery ◽

10.1007/978-1-4615-1851-8_17 ◽

1995 ◽

pp. 153-157

Author(s):

Philip C. Wry ◽

Anthony J. Mure ◽

Steven E. Ross

Keyword(s):

Critically Ill ◽

Trauma Patients

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Augmented Renal Clearance, Muscle Catabolism and Urinary Nitrogen Loss: Implications for Nutritional Support in Critically Ill Trauma Patients

Nutrients ◽

10.3390/nu13103554 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3554

Author(s):

Guilhem Dreydemy ◽

Alexis Coussy ◽

Alexandre Lannou ◽

Laurent Petit ◽

Matthieu Biais ◽

...

Keyword(s):

Renal Clearance ◽

Critically Ill ◽

Nitrogen Balance ◽

Protein Intake ◽

Nitrogen Loss ◽

Secondary Outcome ◽

Trauma Patients ◽

Augmented Renal Clearance ◽

Abdominal Ct ◽

Urinary Nitrogen

The main objective of this pilot study was to determine the association between augmented renal clearance (ARC), urinary nitrogen loss and muscle wasting in critically ill trauma patients. We conducted a retrospective analysis of a local database in 162 critically ill trauma patients without chronic renal dysfunction. Nutritional-related parameters and 24 h urinary biochemical analyses were prospectively collected and averaged over the first ten days after admission. Augmented renal clearance was defined by a mean creatinine clearance (CLCR) > 130 mL/min/1.73 m2. The main outcome was the cumulated nitrogen balance at day 10. The secondary outcome was the variation of muscle psoas cross-sectional area (ΔCSA) calculated in the subgroup of patients who underwent at least two abdominal CT scans during the ICU length of stay. Overall, there was a significant correlation between mean CLCR and mean urinary nitrogen loss (normalized coefficient: 0.47 ± 0.07, p < 0.0001). ARC was associated with a significantly higher urinary nitrogen loss (17 ± 5 vs. 14 ± 4 g/day, p < 0.0001) and a lower nitrogen balance (−6 ± 5 vs. −4 ± 5 g/day, p = 0.0002), without difference regarding the mean protein intake (0.7 ± 0.2 vs. 0.7 ± 0.3 g/kg/day, p = 0.260). In the subgroup of patients who underwent a second abdominal CT scan (N = 47), both ΔCSA and %ΔCSA were higher in ARC patients (−33 [−41; −25] vs. −15 [−29; −5] mm2/day, p = 0.010 and −3 [−3; −2] vs. −1 [−3; −1] %/day, p = 0.008). Critically ill trauma patients with ARC are thus characterized by a lower nitrogen balance and increased muscle loss over the 10 first days after ICU admission. The interest of an increased protein intake (>1.5 g/kg/day) in such patients remains a matter of controversy and must be confirmed by further randomized trials.

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