Prospective Study Evaluating the Prevalence of Intestinal Dysfunction in Hematology Patients Hospitalized in Intensive Care for Sepsis or Septic Shock
The intestinal tract has multiple functions within the body beyond its primary function of nutrient absorption. It acts as a true barrier protecting the body from living microorganisms and antigens in the intestinal lumen. Impairment of any component of the intestinal barrier results in nutrient malabsorption, an altered local digestive immune response, and increased intestinal permeability. The primary function of this barrier is to limit the access of the contents of the intestinal lumen, which particularly includes the bacterial components of the microbiota, to the internal environment and the circulation. This physical barrier function is provided by a monolayer of epithelial cells, closely connected to each other by intercellular junctions (tight junctions, adherens and desmosomes, as well as by the mucus which covers the apical surface of the cells, the constituents of which, mucins, are secreted by the goblet cells. The term intestinal barrier is also used in a broader sense including a protective role against the invasion of environmental pathogens, while allowing toleranSepsis-associated intestinal failure is often underestimated, yet it is found in 20 to 60% of ICU patients. However, its prognosis is poorly documented. For example, there is no consensus definition of this dysfunction or validated biomarkers for rapid assessment. Consequently, it does not appear in most prognostic scores (SOFA, IGS2, etc.). Intestinal permeability, a risk factor for bacterial translocation when elevated, is increased in ICU patients and associated with multiorgan failure system (MODS), particularly in cases of intestinal fasting. However, there is currently no validated marker of acute intestinal failure in intensive care or intensive care.ce towards commensal flora and foods.
∙ Population with hematologic malignancy
• Patients over 18 years of age
• Suffering from hematologic malignancy
• Admitted to intensive care for sepsis or septic shock according to sepsis definition 3:
‣ Sepsis: organ dysfunction (SOFA \> or = 2) related to a host response to infection
⁃ Septic shock: sepsis with acute circulatory failure and metabolic abnormalities (serum lactate \> 2 mmol/L) and vasopressors
• Patients who have read and understood the information letter and do not object to participating in the study
• Affiliated with or beneficiary of a social security scheme.
∙ Control population
∙ \- Patient aged over 18
∙ Admitted to intensive care for sepsis or septic shock according to the sepsis definition 3:
• Sepsis: organ dysfunction (SOFA \> or = 2) related to a host response to infection
• Septic shock: sepsis with acute circulatory failure and metabolic abnormalities (serum lactate \> 2 mmol/L) and vasopressors
‣ Patient who has read and understood the information letter and does not object to participating in the study
⁃ Member of or beneficiary of a social security scheme