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Open Access 01-12-2017 | Research

Circulating bile acids predict outcome in critically ill patients

Authors: Thomas Horvatits, Andreas Drolz, Karoline Rutter, Kevin Roedl, Lies Langouche, Greet Van den Berghe, Günter Fauler, Brigitte Meyer, Martin Hülsmann, Gottfried Heinz, Michael Trauner, Valentin Fuhrmann

Published in: Annals of Intensive Care | Issue 1/2017

Abstract

Background

Jaundice and cholestatic hepatic dysfunction are frequent findings in critically ill patients associated with increased mortality. Cholestasis in critically ill patients is closely associated with stimulation of pro-inflammatory cytokines resulting in impaired bile secretion and subsequent accumulation of bile acids.

Aim of this study was to evaluate the clinical role of circulating bile acids in critically ill patients.

Methods

Total and individual serum bile acids were assessed via high-performance liquid chromatography in 320 critically ill patients and 19 controls.

Results

Total serum bile acids were threefold higher in septic than cardiogenic shock patients and sixfold higher than in post-surgical patients or controls (p < 0.001). Elevated bile acid levels correlated with severity of illness, renal dysfunction and inflammation (p < 0.05). Total bile acids predicted 28-day mortality independently of sex, age, serum bilirubin and severity of illness (HR 1.041, 95% CI 1.013–1.071, p < 0.005). Best prediction of mortality of total bile acids was seen in patients suffering from septic shock.

Conclusions

Individual and total BAs are elevated by various degrees in different shock conditions. BAs represent an early predictor of short-term survival in a mixed cohort of ICU patients and may serve as marker for early risk stratification in critically ill patients. Future studies should elucidate whether modulation of BA metabolism and signalling influences the clinical course and outcome in critically ill patients.

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Title: Circulating bile acids predict outcome in critically ill patients
Authors: Thomas Horvatits
Andreas Drolz
Karoline Rutter
Kevin Roedl
Lies Langouche
Greet Van den Berghe
Günter Fauler
Brigitte Meyer
Martin Hülsmann
Gottfried Heinz
Michael Trauner
Valentin Fuhrmann
Publication date: 01-12-2017
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2017
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-017-0272-7

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Circulating bile acids predict outcome in critically ill patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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