title: Usefulness of the endotoxin activity assay to evaluate the degree of lung injury.
abstract: OBJECTIVE
  It has been reported that the Pulse Contour Cardiac Output (PiCCO) is very useful mainly in the field of intensive care and treatment to grasp the pathophysiological conditions of pulmonary edema because of its capability of obtaining data such as Pulmonary Vascular Permeability Index (PVPI) and Extra Vascular Lung Water (EVLW). Furthermore, a high degree of usability of various markers has been reported for better understanding of the pathological conditions in cases with septicemia.
  
  
  METHODS
  The correlation between the cardiorespiratory status based upon the PiCCO monitor (EVLW and PVPI) and inflammatory markers including C reactive protein, procalcitonin (PC), and Endotoxin Activity Assay (EAA) were evaluated in 11 severe cases that required treatment with a respirator in an intensive care unit.
  
  
  RESULTS
  The EAA values were significantly higher in patients with abnormal EVLW at 0.46±0.20 compared to the normal EVLW group at 0.21±0.19 (p=0.0064). In a similar fashion, patients with abnormal PVPI values tended to have higher PC levels at 18.9±21.8 compared to normal PVPI cases at 2.4±2.2 (p=0.0676). On the other hand, PVPI was significantly higher in the abnormal EAA group at 3.55±0.48 in comparison with the normal EAA group at 1.99±0.68 (p=0.0029). The abnormal EAA group tended to have higher PVPI values than the normal EAA group.
  
  
  CONCLUSIONS
  The EAA is a measurement method designed to estimate the activity of endotoxins in the whole blood. Our results suggest that the EAA value, which had the greatest correlation with lung disorders diagnosed by the PiCCO monitoring, reflects inflammatory reactions predominantly in the lungs.
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan. sakamoy@cc.saga-u.ac.jp.
authors: Yuichiro
authors: Y
authors: Sakamoto
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Satoshi
authors: S
authors: Inoue
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Takashi
authors: T
authors: Iwamura
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Tomoko
authors: T
authors: Yamashita
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Atsushi
authors: A
authors: Nakashima
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Hiroyuki
authors: H
authors: Koami
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Toru
authors: T
authors: Miike
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Mayuko
authors: M
authors: Yahata
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Hisashi
authors: H
authors: Imahase
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Akiko
authors: A
authors: Goto
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Showgo
authors: S
authors: Narumi
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Miho
authors: M
authors: Ohta
authors: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan.
authors: Chris-Kosuke
authors: CK
authors: Yamada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002302:Cardiac Output / Q000502:physiology; D004731:Endotoxins / Q000097:blood*; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D004731:Endotoxins
keywords: CRP; Endotoxin Activity Assay (EAA); Pulse Contour Cardiac Output (PiCCO); procalcitonin