Although modern ICU provides special life support for critically ill patients, due to severe illness and long-term repeated treatment with chemotherapy, radiotherapy, broad-spectrum antibiotics and immunosuppressive agents, the immunity of the patients is significantly reduced, and the probability of infection is greatly increased. At present, the most common infection strains are gram-negative bacterial infections and invasive fungal infections (invasive fungal infetions, IFI). Endotoxin (ET) is one of the cell wall components of Gram-negative bacteria. It is released into the blood and causes ET and sepsis caused by the death of the bacteria. Therefore, it can be used to monitor bacterial infections. The G test quantitatively detects the level of β-D glucan in plasma (1-3) is an auxiliary indicator for the testing of fungal infections. The clinical significance of ET testing in the infection monitoring of patients with malignant tumors in ICU.
Fig1. Tumor.
The diagnosis and monitoring of infections in patients with ICU malignant tumors have always been the core of ICU's work in cancer specialist hospitals. At present, infection-induced septic shock and multiple organ dysfunction syndrome (MODS) have posed a serious threat to the life prognosis of patients with malignant tumors. The official statistics of WHO statistics show that the probability of death caused by infection accounts for about 25.5% of the total annual death rate. In the diagnosis and treatment of infections, clinicians need to quickly diagnose the infected strains in order to treat patients with drugs, shorten the hospitalization time of patients, and reduce hospitalization costs. Therefore, clinicians urgently need "ideal" bio-combined markers to help to assess the severity and prognosis of infection, and the time of ET testing is short (1h), and the joint testing has great monitoring of bacterial infections and fungal infections s help. Studies have shown that bacterial ET is a stimulating factor that induces the formation of PCT. ET mainly targets Gram-negative bacterial infections, and has a high specificity in the diagnosis of Gram-negative bacterial infections, especially the sensitivity of Gram-negative bacterial infection testing. However, there are certain false negatives and false positives in the testing of ET. For example, in the early stage of large-scale trauma and surgical operations, serum PCT testing will produce false positive results, so it is necessary to closely combine the clinical to give full play to its own advantages.
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