Prognostic impact of fecal pH in critically ill patients
Open Access
- 1 January 2012
- journal article
- Published by Springer Science and Business Media LLC in Critical Care
- Vol. 16 (4), R119
- https://doi.org/10.1186/cc11413
Abstract
We have reported that altered gut flora is associated with septic complications and eventual death in critically ill patients with systemic inflammatory response syndrome. It is unclear how fecal pH affects these patients. We sought to determine whether fecal pH can be used as an assessment tool for the clinical course of critically ill patients. Four hundred ninety-one fecal samples were collected from 138 patients who were admitted to the Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Japan. These patients were treated in the intensive care unit for more than 2 days. Fecal pH, fecal organic acids, and fecal bacteria counts were measured and compared by survived group and nonsurvived group, or nonbacteremia group and bacteremia group. Logistic regression was used to estimate relations between fecal pH, age, sex, or APACHE II score and mortality, and incidence of bacteremia. Differences in fecal organic acids or fecal bacteria counts among acidic, neutral, and alkaline feces were analyzed. The increase of fecal pH 6.6 was significantly associated with the increased mortality (odds ratio, 2.46; 95% confidence interval, 1.25 to 4.82) or incidence of bacteremia (3.25; 1.67 to 6.30). Total organic acid was increased in acidic feces and decreased in alkaline feces. Lactic acid, succinic acid, and formic acid were the main contributors to acidity in acidic feces. In alkaline feces, acetic acid was significantly decreased. Propionic acid was markedly decreased in both acidic and alkaline feces compared with neutral feces. No differences were noted among the groups in bacterial counts. The data presented here demonstrate that the fecal pH range that extended beyond the normal range was associated with the clinical course and prognosis of critically ill patients.Keywords
This publication has 21 references indexed in Scilit:
- Effect of multifibre mixture with prebiotic components on bifidobacteria and stool pH in tube-fed childrenBritish Journal of Nutrition, 2010
- CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care settingAmerican Journal of Infection Control, 2008
- INTESTINAL CROSSTALKShock, 2007
- Lactose Intolerance in Infants, Children, and AdolescentsPEDIATRICS, 2006
- Altered Gut Flora and Environment in Patients with Severe SIRSThe Journal of Trauma and Acute Care Surgery, 2006
- Increased iNOS Activity is Essential for Intestinal Epithelial Tight Junction Dysfunction in Endotoxemic MiceShock, 2004
- Intestinal luminal pH in inflammatory bowel disease: possible determinants and implications for therapy with aminosalicylates and other drugsGut, 2001
- Correlation between water‐holding capacity of different types of cellulose in vitro and gastrointestinal retention time in vivo of ratsJournal of the Science of Food and Agriculture, 1992
- Effects of lactulose and other laxatives on ileal and colonic pH as measured by a radiotelemetry deviceGut, 1974
- THE pH AND BUFFERING POWER OF HUMAN BILEThe Lancet, 1955