The Value Of Citrulline To Acute Gastrointestinal Injury In Pediatric Critical Care Unit

Objective:Our study aims at observing the occurrence of acute gastrointestinal injury under different critical state in pediatric care unit, assessing the connection between citrulline and acute gastrointestinal injury, studying the role of cirtrullin in evaluating the patient’s condition prognosis and changes to critically ill children.Methods:Ninety-six pediatric patients admitted to the second hospital of Lanzhou University were selected from October 2013 to May 2014,excluded those with primary gastrointestinal diseases and chronic kidney disease 2ml blood was taken from radial artery within 24 hours of admission,11 patients’ blood were taken again after three days.The blood was collected in Anticoagulation tube at room temperature for 30min,and serum was separated by centrifugal machine for 10min at 4℃,And then the serum samples were stored-80℃. We measured the serum concentrations of citrullin by High Performance Liquid Chromatography.Results:The incidence of acute gastrointestinal injuries in non-critical group,critical group, reorganization critical group were 47.06%,75.00%,92.86%(X2=11.848, P= 0.003<0.05). The average length of stay in hospital of non-gastrointestinal injury group and gastrointestinal injury group were 10.59+7.10 days,14.88+9.96 days, the difference was statistically significant (t= 2.072, P= 0.041<0.05).The serum citrulline concentrations of gastrointestinal injury group and non- gastrointestinal injury group were 14.655±8.231 umol/L,23.522±11.079umol/L (t= 4.398, P<0.05). The area under the ROC curve of citrulline is 79.8%.Serum citrulline concentrations increased significantly after 3 days of treatment compared with admission (t= 3.105, P= 0.011<0.05). The lower serum citrulline levels children had, the higher mortality there were.There were negative correlations among serum citrullin and CRP, PCT and length of hospital stay. There were no correlations among serum citrulline and blood urea nitrogen, lactic acid, albumin,and bilirubin levels.Conclusion:Serum citrulline can become a reliable marker to diagnose the acute gastrointestinal injury with high level of sensitivity specificity. It may well reflect the extent of acute gastrointestinal injury and the outcome.The more critically ill children had the higher incidence of acute gastrointestinal injury and acute gastrointestinal injury may lead to the occurrence of prolonged hospitalization and mortality rate.