Potential interests of citrulline in critically ill patients

Abstract

Due to its highly specific metabolism, citrulline (CIT) is now recognized as a biomarker of functional intestinal mass. In the stressed and septic critically ill patient, plasma CIT is often very low at ∼10 μmol/L (normal range: 38±8 μmol/L). These abnormal values are difficult to interpret as patients may present increased CIT recycling into arginine and/or arginine depletion. Additionally, multiple organ failure may further make this issue complex. Experimental studies in rodent models of sepsis have raised promising results, particularly regarding gut microcirculation, which now need to be confirmed by ongoing randomized clinical trials.