OBJECTIVE: To evaluate the prevalence and time course of systemic @entity5694 following severe @entity1230 , to define its risk factors, and to explore the correlation between post- @entity130 @entity5694 and @entity881 . DESIGN: Prospective single-center cohort study. SETTING: Emergency department and ICU of adult tertiary care level I @entity130 center. @entity1 : Forty-eight severely injured (Injury Severity Score >=  16) @entity1 , admitted to ICU within 24 hours of injury. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Endotoxemia was not evident on initial presentation, but developed subsequently in 75% of @entity1 , even in the absence of Gram-negative @entity281 . Nonsurviving @entity1 had higher endotoxin levels than survivors on day 1 ( @entity5694 , 0.48 vs 0.28; p = 0.048). Shock at admission, or surgery within the first 48 hours after @entity130 , was associated with higher endotoxin levels and predicted subsequent maximal @entity5694 , after adjusting for other significant covariates. @entity5694 levels were higher in @entity1 who developed @entity881 , reflected in a cumulative Multiple Organ Dysfunction Score greater than 25, and @entity1 with an intermediate @entity5694 level (>=  0.4) had more @entity65 . CONCLUSIONS: It is the first study to detect increasing levels of @entity5694 following @entity1230 . Shock and early surgery predict the development of @entity5694 ; @entity5694 is particularly associated with @entity65 . However, Gram-negative @entity281 are uncommon in these @entity1 , suggesting that the gastrointestinal tract is the dominant reservoir of endotoxin. Endotoxin may be an appropriate therapeutic target in @entity1 who have sustained severe @entity1230 .

Endotoxemia Following XXXX : Risk Factors and Prognostic Implications.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity5694 :: ('MESH:D019446', 'Disease') :: ['Maximal endotoxemia', 'endotoxemia'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection', 'infections'] @entity1230 :: ('MESH:D009104', 'Disease') :: ['multiple trauma'] @entity881 :: ('MESH:D009102', 'Disease') :: ['organ dysfunction'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular dysfunction'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity1230 :: (MESH:D009104,Disease) :: ['Multiple Trauma']
