Plasma citrulline in the critically ill: intriguing biomarker, cautious interpretation.

Gaël Piton,Gilles Capellier

doi:10.1186/s13054-015-0881-1

Abstract

In a recent issue of Critical Care, Poole and colleagues found that plasma citrulline concentration and glucose absorption were reduced in 20 critically ill patients compared with 15 controls; however, the authors found no correlation between these two variables. This study highlights the question of the accuracy of plasma citrulline for assessing small bowel function in critically ill patients. Future studies should take into account the type of intestinal failure considered, the particular metabolism of citrulline, the time of plasma citrulline measurement, as well as the range of citrullinemia considered.

Highlights

In a recent issue of Critical Care, Poole and colleagues found that plasma citrulline concentration and glucose absorption were reduced in 20 critically ill patients compared with 15 controls; the authors found no correlation between these two variables
Citrulline is an amino acid not incorporated into proteins that is mainly synthesized by small bowel enterocytes [4]
The paper of Poole and colleagues [1] is welcomed. They confirmed that plasma citrulline concentration and glucose absorption were lower in 20 critically ill patients compared with 15 controls

Summary

Introduction

In a recent issue of Critical Care, Poole and colleagues found that plasma citrulline concentration and glucose absorption were reduced in 20 critically ill patients compared with 15 controls; the authors found no correlation between these two variables. Evaluating small bowel function and integrity is challenging in the critically ill [2]. Crenn and colleagues [5,6] demonstrated that plasma citrulline concentration was a precise biomarker of small bowel function in patients with short bowel syndrome and villous atrophy-associated small bowel diseases, reflecting * Correspondence: gpiton@chu-besancon.fr 1Medical Intensive Care Unit, University Hospital, Besançon 25030, France 2Research Unit EA 3920 and SFR FED 4234, University of Franche Comté, Besançon 25030, France Full list of author information is available at the end of the article small bowel length and villi size, respectively.

Results

Conclusion