Cited by 491Sepsis Diagnosis and TreatmentAbdominal Trauma and InjuriesAbdominal Surgery and Complications

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Gut Bacterial Translocation via the Portal Vein: A Clinical Perspective with Major Torso Trauma

MOORE, FREDERICK A., MOORE, ERNEST E., POGGETTI, RENATO, McANENA, OLIVER J., PETERSON, VERLYN M., ABERNATHY, CHARLES M., PARSONS, POLLY E.·1991·The Journal of Trauma: Injury, Infection, and Critical Care

DOI 10.1097/00005373-199105000-00006

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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.

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Claude H. Organ, Jr. Memorial Lecture: Splanchnic hypoperfusion provokes acute lung injury via a 5-lipoxygenase–dependent mechanism
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Down-regulation of toll-like receptor 4 alleviates intestinal ischemia reperfusion injury and acute lung injury in mice
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Energy Expenditure and Protein Requirements Following Burn Injury
Wise, A. K., Hromatka, K. A., & Miller, K. R. (2019) · Nutrition in Clinical Practice · doi:10.1002/ncp.10390 · Cited by 29
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Gut ischemia/reperfusion-induced liver dysfunction occurs despite sustained oxygen consumption
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LYMPH FROM A PRIMATE BABOON TRAUMA HEMORRHAGIC SHOCK MODEL ACTIVATES HUMAN NEUTROPHILS
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Benchmarking the incidence of organ failure after injury at trauma centers and nontrauma centers in the United States
Benns, M. V., Carr, B. G., Kallan, M. J., & Sims, C. A. (2013) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e31829cfa19 · Cited by 26
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Microcirculatory perfusion deficits are not essential for remote parenchymal injury within the liver
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Emodin Ameliorates Intestinal Dysfunction by Maintaining Intestinal Barrier Integrity and Modulating the Microbiota in Septic Mice
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Inhibition of Enteral Enzymes by Enteroclysis with Nafamostat Mesilate Reduces Neutrophil Activation and Transfusion Requirements after Hemorrhagic Shock
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Microbiote intestinal et dialogue immunitaire au cours de la maladie métabolique
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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
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1991-05
Volume: 31
Issue: 5
Pages: 629-638
ISSN: 0022-5282 (ISSN-L)
DOI: 10.1097/00005373-199105000-00006
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 › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Health Sciences › Medicine › Surgery › Abdominal Trauma and Injuries
Health Sciences › Medicine › Surgery › 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

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Gut Bacterial Translocation via the Portal Vein: A Clinical Perspective with Major Torso Trauma

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