Gut Bacterial Translocation via the Portal Vein: A Clinical Perspective with Major Torso Trauma
Abstract
Animal studies implicate gut bacterial translocation via the portal vein as a major factor in the pathogenesis of postinjury multiple organ failure (MOF). We therefore inserted portal vein catheters for sequential blood sampling in the operating room, at 6, 12, 24, and 48 hours, and 5 days postoperatively in 20 injured patients (13 blunt, seven penetrating; mean age, 34 years) requiring emergent laparotomy and who were at known risk for MOF. The mean Revised Trauma Score was 6.4 +/- 0.4, and the Injury Severity Score, 29.3 +/- 2.3. Twelve (60%) patients arrived in shock (SBP less than 90 torr). Eight (2%) of 212 portal blood cultures were positive; seven were presumed contaminants. The only positive systemic culture (total, 212) was a Staphylococcus aureus on day 5 in a patient with a concurrent staphyloccal pneumonia. In the first 48 hours, we could not detect endotoxin in portal or systemic blood. Additionally, simultaneous portal and systemic blood levels of complement fragment C3a, tumor necrosis factor, and interleukin-6 were nearly identical and, specifically, were not different in those patients who developed MOF. In summary, this prospective clinical study has not confirmed portal or systemic bacteremia within the first 5 days postinjury, despite an eventual 30% incidence of MOF.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In trauma patients at high risk of multiorgan failure, serial blood cultures from indwelling portal vein catheters show minimum evidence of bacterial translocation and no association between portal vein bacteraemia and subsequent illness.
“in a study of trauma patients at high risk of multiorgan failure,101 serial blood cultures drawn from indwelling portal vein catheters have shown minimum evidence of bacterial translocation and no association between portal vein bacteraemia and subsequent illness.”
From The microbiome and critical illness (2016) · cites this paper as [101]
Cited by
Sorted by citations
Metabolic Endotoxemia Initiates Obesity and Insulin Resistance
Cani, P. D., Amar, J., Iglesias, M. A., Poggi, M., Knauf, C., Bastelica, D., Neyrinck, A. M., Fava, F., Tuohy, K. M., Chabo, C., et al. (2007) · Diabetes · doi:10.2337/db06-1491 · Cited by 6,638 · see citing works
“Endogenous LPS is continually produced within the gut by the death of Gram-negative bacteria (27) and is absorbed into intestinal capillaries (28,29) to be transported by lipoproteins (14,15).”
BackgroundCirculating mitochondrial DAMPs cause inflammatory responses to injury
Zhang, Q., Raoof, M., Chen, Y., Sumi, Y., Sursal, T., Junger, W., Brohi, K., Itagaki, K., & Hauser, C. J. (2010) · Nature · doi:10.1038/nature08780 · Cited by 3,812 · see citing works
Moore, F. A., Feliciano, D. V., Andrassy, R. J., McArdle, A. H., Booth, F. V. M., MORGENSTEIN-WAGNER, T. B., Kellum, J. M., Welling, R. E., & Moore, E. E. (1992) · Annals of Surgery · doi:10.1097/00000658-199208000-00008 · Cited by 1,374 · see citing works
Self-citationMultiple Organ Failure Pathophysiology and Potential Future Therapy
Deitch, E. A. (1992) · Annals of Surgery · doi:10.1097/00000658-199208000-00002 · Cited by 1,378 · see citing works
Kudsk, K. A., Croce, M. A., Fabian, T. C., Minard, G., Tolley, E. A., PORET, H. A., KUHL, M. R., & Brown, R. O. (1992) · Annals of Surgery · doi:10.1097/00000658-199205000-00013 · Cited by 1,149 · see citing works
The role of the gut microbiota in energy metabolism and metabolic disease
Cani, P., & Delzenne, N. (2009) · Current Pharmaceutical Design · doi:10.2174/138161209788168164 · Cited by 974 · see citing works
“We hypothesized that the bacterial lipopolysaccharide (LPS) could be the eligible candidate, for the following reasons : 1) LPS is a constituent of Gram negative bacteria present in the gut microbiota, 2) LPS triggers the secretion of proinflammatory cytokines when it binds to the complex of CD14 and the tolllike rece…”
BackgroundDickson, R. P., Singer, B. H., Newstead, M. W., Falkowski, N. R., Erb-Downward, J. R., Standiford, T. J., & Huffnagle, G. B. (2016) · Nature Microbiology · doi:10.1038/nmicrobiol.2016.113 · Cited by 724 · see citing works
Roumen, R. M. H., Hendriks, T., van der Ven‐Jongekrijg, J., Nieuwenhuijzen, G. A. P., Sauerwein, R. W., van der Meer, J. W. M., & Goris, R. J. A. (1993) · Annals of Surgery · doi:10.1097/00000658-199312000-00011 · Cited by 617 · see citing works
Microfluidic Organ-on-a-Chip Models of Human Intestine
Bein, A., Shin, W., Jalili-Firoozinezhad, S., Park, M. H., Sontheimer-Phelps, A., Tovaglieri, A., Chalkiadaki, A., Kim, H. J., & Ingber, D. E. (2018) · Cellular and Molecular Gastroenterology and Hepatology · doi:10.1016/j.jcmgh.2017.12.010 · Cited by 601 · see citing works
Innate immune responses to trauma
Huber-Lang, M. S., Lambris, J. D., & Ward, P. A. (2018) · Nature Immunology · doi:10.1038/s41590-018-0064-8 · Cited by 604 · see citing works
Role of the Gut in Multiple Organ Failure: Bacterial Translocation and Permeability Changes
Swank, G. M., & Deitch, E. A. (1996) · World Journal of Surgery · doi:10.1007/s002689900065 · Cited by 565 · see citing works
“clinical relevance of gut-origin septic states [43, 44]: In neither”
BackgroundEvolving Concepts in the Pathogenesis of Postinjury Multiple Organ Failure
Moore, F. A., & Moore, E. E. (1995) · Surgical Clinics of North America · doi:10.1016/s0039-6109(16)46587-4 · Cited by 525 · see citing works
Self-citationInterleukin-6 in the injured patient. Marker of injury or mediator of inflammation?
Biffl, W., Moore, E. E., Moore, F., & Peterson, V. M. (1996) · Annals of Surgery · doi:10.1097/00000658-199611000-00009 · Cited by 558 · see citing works
Self-citationPostinjury Multiple Organ Failure: A Bimodal Phenomenon
Moore, F. A., Sauaia, A., Moore, E. E., Haenel, J. B., Burch, J. M., & Lezotte, D. C. (1996) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-199604000-00001 · Cited by 491 · see citing works
Self-citationEarly Predictors of Postinjury Multiple Organ Failure
Sauaia, A. (1994) · Archives of Surgery · doi:10.1001/archsurg.1994.01420250051006 · Cited by 487 · see citing works
The microbiome and critical illness
Dickson, R. P. (2016) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(15)00427-0 · Cited by 460 · see citing works
Bacterial translocation from the gastrointestinal tract
Berg, R. D. (1995) · Trends in Microbiology · doi:10.1016/s0966-842x(00)88906-4 · Cited by 443 · see citing works
Clark, J. A., & Coopersmith, C. M. (2007) · Shock · doi:10.1097/shk.0b013e31805569df · Cited by 443 · see citing works
“There is strong evidence that loss of barrier function is an early event in critical illness, although conclusive data that this leads to translocation of bacteria or other luminal contents in patients has not been firmly established (48).”
BackgroundMechanisms of sepsis-induced organ dysfunction
Abraham, E. H., & Singer, M. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000282072.56245.91 · Cited by 442 · see citing works
“An example is translocation of endotoxin from the gut into portal and lymphatic drainage systems (31).”
BackgroundThe Gut as the Motor of Multiple Organ Dysfunction in Critical Illness
Klingensmith, N. J., & Coopersmith, C. M. (2016) · Critical Care Clinics · doi:10.1016/j.ccc.2015.11.004 · Cited by 423 · see citing works
“While bacterial translocation clearly occurs in some preclinical models of critical illness (10), human data has generally remained inconclusive or not supportive of this as a common phenomenon seen in critically ill patients, although it likely occurs in select pathophysiologic conditions (11;12).”
BackgroundMagnotti, L. J., Upperman, J. S., Xu, D.-Z., Lu, Q., & Deitch, E. A. (1998) · Annals of Surgery · doi:10.1097/00000658-199810000-00008 · Cited by 414 · see citing works
Guidelines for enteral feeding in adult hospital patients
Stroud, M. A., Duncan, H., & Nightingale, J. (2003) · Gut · doi:10.1136/gut.52.suppl_7.vii1 · Cited by 411 · see citing works
“It may also help to maintain gut barrier function 12 13 although there is little evidence that it reduces bacterial translocation in humans.”
BackgroundBacterial Translocation from the Gastrointestinal Tract
Berg, R. D. (1999) · Advances in experimental medicine and biology · doi:10.1007/978-1-4615-4143-1_2 · Cited by 407 · see citing works
Muckart, D. J. J., & Bhagwanjee, S. (1997) · Critical Care Medicine · doi:10.1097/00003246-199711000-00014 · Cited by 385 · see citing works
Pape, H., Hildebrand, F., Pertschy, S., Zelle, B. A., Garapati, R., Grimme, K., & Krettek, C. (2002) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-200209000-00010 · Cited by 377 · see citing works
Bacterial translocation: Overview of mechanisms and clinical impact
Balzan, S. M. P., Quadros, C. A., de Cleva, R., Zilberstein, B., & Cecconello, I. (2007) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2007.04933.x · Cited by 370 · see citing works
The role of the gut microbiota in sepsis
Haak, B. W., & Wiersinga, W. J. (2017) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(16)30119-4 · Cited by 375 · see citing works
Gut-origin sepsis: evolution of a concept
Deitch, E. A. (2012) · The Surgeon · doi:10.1016/j.surge.2012.03.003 · Cited by 359 · see citing works
“One potential explanation for the failure of Moore et al.27 to find bacteria or endotoxin in the portal system of patients with MODS is that gut-derived, MODS-inducing factors were exiting the gut via the intestinal lymphatics rather than the portal blood (Fig.”
BackgroundMITOCHONDRIAL DNA IS RELEASED BY SHOCK AND ACTIVATES NEUTROPHILS VIA P38 MAP KINASE
Zhang, Q., Itagaki, K., & Hauser, C. J. (2010) · Shock · doi:10.1097/shk.0b013e3181cd8c08 · Cited by 354 · see citing works
“Many hypotheses have been advanced to explain the relationship between shock and inflammation including Bmicrocirculatory dysfunction[ (25, 26) and Bgut origin sepsis[ (27, 28).”
BackgroundRedefining the gut as the motor of critical illness
Mittal, R., & Coopersmith, C. M. (2013) · Trends in Molecular Medicine · doi:10.1016/j.molmed.2013.08.004 · Cited by 342 · see citing works
“Contrary to prevailing thought, bacteria were detected in portal or systemic blood in only 2% of patients (and endotoxin in no patients) despite a 30% incidence of multiple organ failure (11).”
Selective Decontamination of the Digestive Tract in Surgical Patients
Nathens, A. B. (1999) · Archives of Surgery · doi:10.1001/archsurg.134.2.170 · Cited by 319 · see citing works
“Although a well-established phenomenon in animal models,(22,23) translocation has not been conclusively demonstrated in humans.(24) The standard SDD regimen consists of 2 components.”
BackgroundEndotoxemia: Methods of detection and clinical correlates
Hurley, J. C. (1995) · Clinical Microbiology Reviews · doi:10.1128/cmr.8.2.268 · Cited by 318 · see citing works
“In four small studies of patients at high risk for adult respiratory distress syndrome (ARDS) following trauma, endotoxemia was not found in any patient (77, 93, 147) even when samplings of portal blood were obtained (246).”
BackgroundCoopersmith, C. M. (2002) · JAMA · doi:10.1001/jama.287.13.1716 · Cited by 295 · see citing works
Splanchnic Ischemia and Bacterial Translocation in the Abdominal Compartment Syndrome
Diebel, L. N., Dulchavsky, S. A., & Brown, W. J. (1997) · doi:10.1097/00005373-199711000-00019 · Cited by 289 · see citing works
Schwartz, M. D., Moore, E. E., Moore, F. A., Shenkar, R., Moine, P., Haenel, J. B., & Abraham, E. H. (1996) · Critical Care Medicine · doi:10.1097/00003246-199608000-00004 · Cited by 287 · see citing works
Self-citationIntestinal permeability and systemic infections in critically ill patients: Effect of glutamine*
De-Souza, D. A., & Greene, L. J. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000162680.52397.97 · Cited by 285 · see citing works
“(48), 20 critically ill patients were analyzed after major torso trauma (13 patients with blunt trauma and seven patients with penetrating trauma), some of them in a state of shock at the time of hospitalization (systolic blood pressure 90 torr in 12 patients, i.”
BackgroundPape, H., Rixen, D., Morley, J. R., Husebye, E. E., Mueller, M. R., Dumont, C., Gruner, A., Oestern, H. J., Bayeff-Filoff, M., Garving, C., et al. (2007) · Annals of Surgery · doi:10.1097/sla.0b013e3181485750 · Cited by 280 · see citing works
Burns, Bacterial Translocation, Gut Barrier Function, and Failure
Magnotti, L. J., & Deitch, E. A. (2005) · Journal of Burn Care & Rehabilitation · doi:10.1097/01.bcr.0000176878.79267.e8 · Cited by 277 · see citing works
The role of the gastrointestinal tract in postinjury multiple organ failure
Moore, F. A. (1999) · The American Journal of Surgery · doi:10.1016/s0002-9610(99)00231-7 · Cited by 268 · see citing works
Self-citationPape, H., Grimme, K., van Griensven, M., Sott, A. H., Giannoudis, P. V., Morley, J. R., Røise, O., Ellingsen, E., Hildebrand, F., Wiese, B., et al. (2003) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000075787.69695.4e · Cited by 265 · see citing works
Cani, P. D., Delzenne, N. M., Amar, J., & Burcelin, R. (2008) · Pathologie Biologie · doi:10.1016/j.patbio.2007.09.008 · Cited by 264 · see citing works
“Importantly, the bacterial lineage was constant one year after the dietary intervention for a given body weight, validating the bacterial signature of each individual.”
BackgroundWanner, G. A., Keel, M. J. B., Steckholzer, U., Beier, W., Stocker, R. A., & Ertel, W. (2000) · Critical Care Medicine · doi:10.1097/00003246-200004000-00007 · Cited by 263 · see citing works
“Severe trauma represents an insult that causes a wide array of pathophysiologic alterations including hemorrhagic shock, hypoxia, hypotension, or even the invasion of bacterial compounds from the gut into the circulation ("bacterial translocation") (29, 30).”
BackgroundRole of the gut lymphatic system in multiple organ failure
Deitch, E. A. (2001) · Current Opinion in Critical Care · doi:10.1097/00075198-200104000-00007 · Cited by 249 · see citing works
Postinjury neutrophil priming and activation: An early vulnerable window*
Botha, A. J., Moore, F. A., Moore, E. E., KIM, F., BANERJEE, A., & Peterson, V. M. (1995) · Surgery · doi:10.1016/s0039-6060(05)80345-9 · Cited by 252 · see citing works
Self-citationTiming of Fixation of Major Fractures in Blunt Polytrauma
Pape, H., Giannoudis, P. V., Krettek, C., & Trentz, O. (2005) · Journal of Orthopaedic Trauma · doi:10.1097/01.bot.0000161712.87129.80 · Cited by 250 · see citing works
“When 3 groups of patients with similar injuries were separated according to the duration of initial surgery, patients with the longest initial surgery (.6 hours) developed a significantly higher complication rate, namely ARDS and MOF.143 These results support the idea that orthopaedic surgeons play a pivotal role in i…”
BackgroundInfluentialGut-origin sepsis in the critically ill patient: pathophysiology and treatment
Assimakopoulos, S. F., Triantos, C., Thomopoulos, K., Fligou, F., Maroulis, I., Marangos, M., & Gogos, C. A. (2018) · Infection · doi:10.1007/s15010-018-1178-5 · Cited by 244 · see citing works
Peitzman, A. B., Harbrecht, B. G., Udekwu, A. O., Billiar, T. R., Kelly, E., & Simmons, R. L. (1995) · Current Problems in Surgery · doi:10.1016/s0011-3840(05)80008-5 · Cited by 249 · see citing works
Deitch, E. A. (2002) · Surgery · doi:10.1067/msy.2002.116408 · Cited by 233 · see citing works
Challenge to the Intestinal Mucosa During Sepsis
Haußner, F., Chakraborty, S., Halbgebauer, R., & Huber-Lang, M. S. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.00891 · Cited by 230 · see citing works
Freestone, P. P. E., WILLIAMS, P. H., Haigh, R., Maggs, A. F., Neal, C. P., & Lyte, M. (2002) · Shock · doi:10.1097/00024382-200211000-00014 · Cited by 227 · see citing works
“Furthermore, the attachment of commensal bacteria to the intestinal mucosa, and possible invasion across the epithelial barrier, has been hypothesized as a possible additional mechanism by which commensal bacteria may play a role in the development of gut-derived sepsis and multiple organ failure following trauma (6–9…”
ResultInfluentialChanges in blood lymphocyte populations after multiple trauma
Menges, T., Engel, J., Welters, I. D., et al. (1999) · Critical Care Medicine · doi:10.1097/00003246-199904000-00026 · Cited by 227 · see citing works
Endotoxemia—menace, marker, or mistake?
Munford, R. S. (2016) · Journal of Leukocyte Biology · doi:10.1189/jlb.3ru0316-151r · Cited by 219 · see citing works
“growing bacteria from mesenteric lymph nodes than from portal blood [25, 26].”
BackgroundA 12-Year Prospective Study of Postinjury Multiple Organ Failure
Ciesla, D. J. (2005) · Archives of Surgery · doi:10.1001/archsurg.140.5.432 · Cited by 2 · see citing works
“In 1987, we developed an MOF scale as a descriptive end point for clinical studies.(17) Since 1992, we have prospectively collected clinical data on patients at risk for postinjury MOF for the first 28 postinjury days.”
MethodSelf-citationPostinjury Inflammation and Organ Dysfunction
Sauaia, A., Moore, F. A., & Moore, E. E. (2016) · Critical Care Clinics · doi:10.1016/j.ccc.2016.08.006 · Cited by 211 · see citing works
Self-citationCitation classics in critical care medicine
Baltussen, A., & Kindler, C. H. (2004) · Intensive Care Medicine · doi:10.1007/s00134-004-2195-7 · Cited by 205 · see citing works
Bacterial translocation in the gut
Wiest, R., & Rath, H. C. (2003) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/s1521-6918(03)00024-6 · Cited by 204 · see citing works
The inflammatory basis of trauma/shock-associated multiple organ failure
Yao, Y.-M., Redl, H. R., Bahrami, S., & Schlag, G. (1998) · Inflammation Research · doi:10.1007/s000110050318 · Cited by 203 · see citing works
“[126] inserted portal vein catheters for sequential blood sampling in 20 injured patients requiring emergency laparotomy and who were at known risk of MOF.”
Review article: bacterial translocation in the critically ill – evidence and methods of prevention
Gatt, M., REDDY, B. S., & Macfie, J. M. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.03174.x · Cited by 201 · see citing works
Gut lymph and lymphatics: a source of factors leading to organ injury and dysfunction
Deitch, E. A. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2010.05713.x · Cited by 200 · see citing works
Gut microbiota and immune crosstalk in metabolic disease
Burcelin, R. (2016) · Molecular Metabolism · doi:10.1016/j.molmet.2016.05.016 · Cited by 191 · see citing works
“The translocation of full live bacteria from the intestine to tissues has been described in many instances [72] such as in response to a state of immunodeficiency [73], major tissue stress [74], short bowel inflammatory disease [75], infections [76], and streptozotocin-induced Langerhans islet cell destruction [77].”
BackgroundSHANAB, A. A. A., Scully, P., Crosbie, O. M., Buckley, M. J. M., O’Mahony, L., Shanahan, F., Gazareen, S., Murphy, E., & Quigley, E. M. M. (2010) · Digestive Diseases and Sciences · doi:10.1007/s10620-010-1447-3 · Cited by 189 · see citing works
“Endogenous lipopolysaccharide (LPS) is continuously released from the gut after the death of Gram-negative bacteria [29] and is then transported via a toll-like receptor 4 (TLR-4)-dependent process into intestinal capillaries [30–32].”
BackgroundThe intestinal microenvironment in sepsis
Fay, K. T., Ford, M. L., & Coopersmith, C. M. (2017) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2017.03.005 · Cited by 188 · see citing works
“Further, in a classic study of trauma patients – who typically have intestinal hyperpermeability -- catheters placed in the portal venous system demonstrated intact bacteria less than ten percent of the time (13).”
BackgroundEarly Definitive Stabilization of Unstable Pelvis and Acetabulum Fractures Reduces Morbidity
Vallier, H. A., Cureton, B. A., Ekstein, C., et al. (2010) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e3181e50914 · Cited by 180 · see citing works
Translocation of gut flora and its role in sepsis
Vaishnavi, C. V. (2013) · Indian Journal of Medical Microbiology · doi:10.4103/0255-0857.118870 · Cited by 175 · see citing works
Early Complementopathy After Multiple Injuries in Humans
Burk, A.-M., Martin, M., Flierl, M. A., Rittirsch, D., Helm, M., Lampl, L. A., Brückner, U. B., Stahl, G. L., Blom, A. M., Perl, M., et al. (2012) · Shock · doi:10.1097/shk.0b013e3182471795 · Cited by 173 · see citing works
“However, despite detection of increased serum anaphylatoxin concentrations after trauma, clinical studies failed to confirm C3a or other complement fragments as specific markers for adult respiratory distress syndrome or multiple-organ failure (28, 29).”
BackgroundTrauma alarmins as activators of damage-induced inflammation
Manson, J., Thiemermann, C., & Brohi, K. (2011) · British journal of surgery · doi:10.1002/bjs.7717 · Cited by 174 · see citing works
Review article: intestinal failure
Lal, S., Teubner, A., & Shaffer, J. (2006) · Alimentary Pharmacology and Therapeutics · doi:10.1111/j.1365-2036.2006.02941.x · Cited by 141 · see citing works
Serum Levels of Hsp 72 Measured Early after Trauma Correlate with Survival
Pittet, J., Lee, H., Morabito, D. J., Howard, M., Welch, W. J., & Mackersie, R. C. (2002) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-200204000-00001 · Cited by 160 · see citing works
Partrick, D. A., Moore, F. A., Moore, E. E., Biffl, W. L., Sauaia, A., & Barnett, C. C. (1996) · The American Journal of Surgery · doi:10.1016/s0002-9610(96)00252-8 · Cited by 159 · see citing works
Self-citationRoumen, R. M. H. (1993) · Archives of Surgery · doi:10.1001/archsurg.1993.01420160095016 · Cited by 159 · see citing works
Carsin, H., Assicol, M., Féger, F., et al. (1997) · Burns · doi:10.1016/s0305-4179(96)00124-6 · Cited by 155 · see citing works
Panzer, A. R., Lynch, S. V., Langelier, C., Christie, J. D., McCauley, K. E., Nelson, M. F., Cheung, C. K., Benowitz, N. L., Cohen, M. J. M., & Calfee, C. S. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201702-0441oc · Cited by 152 · see citing works
Pathophysiology in patients with polytrauma
Pape, H., Moore, E. E., McKinley, T. O., & Sauaia, A. (2022) · Injury · doi:10.1016/j.injury.2022.04.009 · Cited by 153 · see citing works
Self-citationIntestinal Permeability Correlates with Severity of Injury in Trauma Patients
Faries, P. L., Simón, R., Martella, A. T., Lee, M. J., & Machiedo, G. W. (1998) · doi:10.1097/00005373-199806000-00016 · Cited by 148 · see citing works
Deitch, E. A., Adams, C. A., Lu, Q., & Xu, D.-Z. (2001) · Surgery · doi:10.1067/msy.2001.109119 · Cited by 146 · see citing works
VALIDATION OF POSTINJURY MULTIPLE ORGAN FAILURE SCORES
Sauaia, A., Moore, E. E., Johnson, J. L., Ciesla, D. J., Biffl, W. L., & Banerjee, A. M. (2009) · Shock · doi:10.1097/shk.0b013e31818ba4c6 · Cited by 143 · see citing works
“The Denver MOF score was first proposed in 1991 as part of a National Institutes of Health Center Project (34), then modified in 1993 (35) by a panel of expert trauma surgeons and trauma investigators.”
MethodSelf-citationThe role of the gut in the development of multiple organ dysfunction in cardiothoracic patients
Baue, A. E. (1993) · The Annals of Thoracic Surgery · doi:10.1016/0003-4975(93)90098-3 · Cited by 147 · see citing works
Current status of bacterial translocation as a cause of surgical sepsis
MacFie, J. (2004) · British Medical Bulletin · doi:10.1093/bmb/ldh029 · Cited by 145 · see citing works
Hauser, C. J., Zhou, X., Joshi, P. C., Cuchens, M. A., Kregor, P. J., Devidas, M., Kennedy, R. J., Poole, G. V., & Hughes, J. L. (1997) · doi:10.1097/00005373-199705000-00021 · Cited by 140 · see citing works
The digestive tract as the origin of systemic inflammation
de Jong, P. R., González-Navajas, J. M., & Jansen, N. J. G. (2016) · Critical Care · doi:10.1186/s13054-016-1458-3 · Cited by 141 · see citing works
“It is important to point out here that, in a classic study, portal vein sampling in trauma patients undergoing laparotomy did not provide evidence for bacterial translocation by blood cultures [43].”
BackgroundMultiple Organ Dysfunction Syndrome
Gourd, N. M., & Nikitas, N. (2019) · Journal of Intensive Care Medicine · doi:10.1177/0885066619871452 · Cited by 137 · see citing works
Bennett‐Guerrero, E. (1997) · JAMA · doi:10.1001/jama.1997.03540320048034 · Cited by 130 · see citing works
Increased gut permeability after multiple trauma
Pape, H., Dwenger, A., Regel, G., et al. (1994) · British journal of surgery · doi:10.1002/bjs.1800810619 · Cited by 129 · see citing works
Baterial Translocation in Humans
Lichtman, S. N. (2001) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-200107000-00001 · Cited by 126 · see citing works
“(43) obtained portal venous blood cultures and endotoxin concentrations in 20 patients.”
BackgroundSplanchnic ischaemia/reperfusion and multiple organ failure
Biffl, W. L., & Moore, E. E. (1996) · British Journal of Anaesthesia · doi:10.1093/bja/77.1.59 · Cited by 123 · see citing works
“Although we had not found evidence of bacterial translocation in our severely injured patients who developed MOF [90], we were interested in whether LPS was involved in PMN priming in our I/R model.”
BackgroundMethodInfluentialSelf-citationWickel, D. J., Cheadle, W. G., Mercer-Jones, M. A., et al. (1997) · Annals of Surgery · doi:10.1097/00000658-199706000-00012 · Cited by 122 · see citing works
Bacterial translocation in multiple organ failure: Cause or epiphenomenon still unproven
Lemaire, L. C. J. M., van Lanschot, J. J. B., Stoutenbeek, C. P., van Deventer, S. J. H., Wells, C. L., & Gouma, D. J. (1997) · British journal of surgery · doi:10.1111/j.1365-2168.1997.00520.x · Cited by 127 · see citing works
Early Cytokine Production Risk Stratifies Trauma Patients for Multiple Organ Failure
Jastrow, K. M., Gonzalez, E. A., McGuire, M. F., Suliburk, J. W., Kozar, R. A., Iyengar, S., Motschall, D., McKinley, B. A., Moore, F. A., & Mercer, D. (2009) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2009.05.002 · Cited by 118 · see citing works
Self-citationThe Horror Autotoxicus and Multiple-Organ Failure
Baue, A. E. (1992) · Archives of Surgery · doi:10.1001/archsurg.1992.01420120085016 · Cited by 116 · see citing works
Clements, T. W., Tolonen, M., Ball, C. G., & Kirkpatrick, A. W. (2021) · Scandinavian Journal of Surgery · doi:10.1177/1457496920984078 · Cited by 115 · see citing works
“Nonetheless, bacterial translocation through the portal system was long been a favored mechanism of systemic insult in abdominal pathology, but this theory now has been superseded by the gut-lymph hypothesis, as systemic sepsis from intra-abdominal sources happens in the absence of clear bacterial translocation (50).”
BackgroundThe role of the lung in postinjury multiple organ failure
Ciesla, D. J., Moore, E. E., Johnson, J. L., Burch, J. M., Cothren, C. C., & Sauaia, A. (2005) · Surgery · doi:10.1016/j.surg.2005.07.020 · Cited by 113 · see citing works
Self-citationDeitch, E. A., Forsythe, R. M., Anjaria, D. J., Livingston, D. H., Lu, Q., Xu, D.-Z., & Redl, H. (2004) · Shock · doi:10.1097/01.shk.0000133592.55400.83 · Cited by 113 · see citing works
“Specifically, this concept that the mesenteric lymphatics rather than the portal blood is the major route by which tissue injurious factors exit the gut after gut injury helps explain how the gut can contribute to distant organ injury and yet the portal vein of trauma patients not contain bacteria or endotoxin (18).”
BackgroundMicrobial Translocation in Neonates and Infants Receiving Long-term Parenteral Nutrition
Pierro, A. (1996) · Archives of Surgery · doi:10.1001/archsurg.1996.01430140066018 · Cited by 112 · see citing works
Alterations in intestinal microbial flora and human disease
Othman, M. O., Agüero, R., & Lin, H. C. (2008) · Current Opinion in Gastroenterology · doi:10.1097/mog.0b013e3282f2b0d7 · Cited by 112 · see citing works
“Although it was demonstrated in animal models that bacteria translocate to mesenteric lymph nodes and enter the circulation through portal blood [70], a prospective human trial failed to detect a significant level of bacteria, bacterial endotoxin or inflammatory markers in the portal circulation of patients with major…”
BackgroundAmornphimoltham, P., Yuen, P. S. T., Star, R. A., & Leelahavanichkul, A. (2019) · Digestive Diseases and Sciences · doi:10.1007/s10620-019-05581-y · Cited by 108 · see citing works
Posthemorrhagic Shock Mesenteric Lymph Primes Circulating Neutrophils and Provokes Lung Injury
Zallen, G. S., Moore, E. E., Johnson, J. L., Tamura, D. Y., Ciesla, D. J., & Silliman, C. C. (1999) · Journal of Surgical Research · doi:10.1006/jsre.1999.5569 · Cited by 107 · see citing works
Self-citationSenthil, M., Brown, M., Xu, D.-Z., Lu, Q., Feketeova, E., & Deitch, E. A. (2006) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000215500.00018.47 · Cited by 104 · see citing works
Endothelial cell activity varies in patients at risk for the adult respiratory distress syndrome
Moss, M. M., Gillespie, M. K., Ackerson, L., et al. (1996) · Critical Care Medicine · doi:10.1097/00003246-199611000-00004 · Cited by 103 · see citing works
Self-citationShenkar, R., Coulson, W. F., & Abraham, E. (1994) · American Journal of Respiratory Cell and Molecular Biology · doi:10.1165/ajrcmb.10.3.8117448 · Cited by 102 · see citing works
Intestinal permeability is increased after major vascular surgery
Roumen, R. M. H., van der Vliet, J. A., Wevers, R. A., et al. (1993) · Journal of Vascular Surgery · doi:10.1016/0741-5214(93)90118-6 · Cited by 98 · see citing works
- Authors
- MOORE, F. A., MOORE, E. E., POGGETTI, R., McANENA, O. J., PETERSON, V. M., ABERNATHY, C. M., & PARSONS, P. E.
- Affiliations
- Denver Health Medical Center (US)
- ORCID
- MOORE, ERNEST E.
- Venue
- The Journal of Trauma: Injury, Infection, and Critical Care
- Published
- 1991-05
- Volume
- 31
- Issue
- 5
- Pages
- 629-638
- ISSN
- 0022-5282 (ISSN-L)
- OpenAlex
- W2053522978
- Cited by
- 491
- References
- 0
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 8 · 2022: 5 · 2021: 3 · 2020: 12 · 2019: 8 · 2018: 14 · 2017: 18 · 2016: 22 · 2015: 13 · 2014: 9 · 2013: 11 · 2012: 10
- FWCI
- 16.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p50hl040784-10)
- National Heart, Lung, and Blood Institute (P50 HL-40784-01, K08 HLO-1849-04)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Abdominal Trauma and Injuries
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Abdominal Surgery and Complications
- Keywords
- gut bacterial translocation, portal vein, multiple organ failure, bacteremia, trauma (physical injury), endotoxin, complement C3a, TNF-α, interleukin-6, traumatic shock
- MeSH terms
- Abdominal Injuries, Adult, Bacteria, Endotoxins, Humans, Intestines, Multiple Organ Failure, Multiple Trauma, Portal Vein, Prospective Studies, Wounds, Nonpenetrating, Trauma Severity Indices, Interleukin-6, Fractures, Bone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
