Diagnostics of Intestinal Ischemia. Influence of Surgery on Plasma Levels of I-FABP as the Marker of Enterocyte Injury

Česká verzia

Authors: M. Mitták; T. Karlík ^*
Authors place of work: Chirurgická klinika Fakultní nemocnice Ostrava, přednosta: doc. MUDr. J. Dostalík, CSc. ; Ústav klinické biochemie FN Ostrava ^*
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 1, s. 16-20.
Category: Monothematic special - Original

Summary

Background:
Intestinal fatty acid binding protein (I-FABP) deriving from the cytoplasm of the intestinal epithelial cells is a new biochemical marker with potential to indicate intestinal mucosal injury early in the phase of enterocyte damage. I-FABP is thought to be promising marker for detection of the systemic inflammatory response syndrome (SIRS) and sepsis before its onset.

Aim of the study:
The aim of the study was to consider the influence of surgery on I-FABP plasma levels.

Methods:
Fifty-six consecutive patients undergoing elective surgery were prospectively studied. Only patients with major surgical procedure were involved in the study. Patients were divided into three groups: group A (n = 19) patients with open abdominal surgery, group B (n = 19) patients with laparoscopic abdominal surgery and group C (n = 15) patients with thoracic surgery. From every patient in the study six samples of venous blood were taken in these intervals: preoperatively, immediately postoperatively and 4, 12, 24 and 48 hours after the surgery. Plasma samples were analysed for I-FABP levels by enzyme linked immunosorbent assay.

Results:
There were no differences in the mean plasma I-FABP levels within the groups (ANOVA, p > 0,05), except significant decrease of the I-FABP level 48 hours after the surgery in contrast to preoperative plasma concentration in group B (82.60 pg/ml vs. 229.00 pg/ml; p = 0.025) and group C (88.99 pg/ml vs. 194.96 pg/ml; p=0.0347). There were no differences in the mean I-FABP plasma concentrations among the groups preoperatively, immediately postoperatively and 4, 12, 24 and 48 hours after the surgery (ANOVA, p > 0.05). No differences were found in the I-FABP plasma levels related to preoperative laxative drug use, duration of surgery, small bowel resection and SIRS in postoperative period (t-test, p > 0.05).

Conclusions:
There were no differences in the mean plasma I-FABP levels preoperatively and in the postoperative period after the major surgery. Because surgery alone probably has no influence on I-FABP plasma levels we can say that the concept of I-FABP as the early marker of the intestinal mucosal injury is also viable in postoperative period.

Key words:
intestinal fatty acid binding protein – surgery – mucosal injury – sepsis

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