Evaluation of Fecal Calprotectin, D-Lactic Acid and Bedside Gastrointestinal Ultrasound Image Data for the Prediction of Acute Gastrointestinal Injury in Sepsis Patients

Objective: To investigate the early warning and prognostic evaluation of fecal calprotectin (FC), D-lactic acid, and bedside gastrointestinal ultrasound (B-GIUS) data for acute gastrointestinal injury (AGI) in sepsis patients. Main Method:Sepsis patients were grouped based on the presence or absence of AGI into AGI and non-AGI groups. Healthy volunteers of the same period were selected as the control group. FC, B-GIUS data, D-lactic acid, etc. were collected on the 1st, 3rd and 7th days of admission. Twenty-eight-day mortality was recorded. Main Results: FC, D-lactic acid levels, gastric antrum cross-sectional area, and small intestine wall thickness were significantly increased in group A and B (P 0.05). AUC for D-lactic acid was 0.881, which was higher than FC’s (0.74). When the D-lactic acid cutoff value was 22.16 µmol/L, the sensitivity was 77.9% and the specificity was 92% for the prediction of AGI in sepsis. AUC for the cross-sectional area of the gastrointestinal antrum was 0.657, which was higher than the small intestine thickness’s (0.629). When the gastric antrum cross-sectional area was larger than 4.20 cm2, the sensitivity was 64% and the specificity was 65.3% . Conclusion: D-Lactic acid and FC were early diagnostic indicators for sepsis with AGI, and D-lactic acid was the superior indicator. The gastric antrum cross-sectional area and the thickness of the small intestine had an early warning effect, and the prediction of the gastric antrum cross-sectional area was superior to that of the latter. Because it is noninvasive and convenient, B-GIUS can help in the diagnosis of sepsis with AGI.