Bowel Ischemia in ICU Patients: Diagnostic Value of I-FABP Depends on the Interval to the Triggering Event

Ludewig, Stephan; Jarbouh, Rami; Ardelt, Michael; Mothes, Henning; Rauchfuß, F.; Fahrner, René; Zanow, Jürgen; Settmacher, Utz

doi:10.1155/2017/2795176

“…Therefore, IFABP can reflect intestinal mucosal permeability, and also be considered as a critical indicator of early gastrointestinal failure in critically ill patients. 28 , 29 In this study, the improvement of IFABP in the Tongfu powder group was significantly higher than that in the mosapride group, indicating that Tongfu powder could improve intestinal mucosal permeability of AP patients. 3) Motilin and VIP are gastrointestinal hormones, and motilin is a stimulatory hormone that can accelerate gastric emptying, and VIP is an inhibitory hormone that can relax the digestive tract smooth muscle and slow down gastric emptying.…”

Section: Discussionmentioning

confidence: 54%

Efficacy and safety of Tongfu powder in acute pancreatitis patients with gastrointestinal dysfunction: a clinical trial

Miao¹,

Li²,

Zhang³

et al. 2018

DDDT

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ObjectiveTo evaluate the efficacy and safety of Tongfu powder for external application on Shénquè (the umbilicus, hereafter, Tongfu powder) versus mosapride in acute pancreatitis (AP) patients with gastrointestinal dysfunction.MethodsA total of 102 AP patients were diagnosed using the latest Atlanta Criterion and recruited at the Department of Infectious Disease, Beijing Friendship Hospital (Beijing, People’s Republic of China) from August 2014 to December 2016. Patients were randomized into the Tongfu powder group and mosapride group using the random table. Information on scores (eg, the gastrointestinal function score) on days 1 and 7 of hospitalization, biochemical indicators (eg, interleukin [IL]-2 and IL-6), indicators for curative effects (eg, first defecation time, bowel sound recovery time, hospitalization costs, and duration) were collected and compared between the 2 groups.ResultsThe gastrointestinal function score decreased significantly after treatment, and the changes were significantly different between the Tongfu powder group and the mosapride group (P<0.05). Significantly shorter time to first defecation and bowel sound recovery was observed in the Tongfu powder group versus the mosapride group (P<0.05). The improvements of IL-2, IL-4, intestinal fatty acid binding protein, motilin, and vasoactive intestinal peptide in the Tongfu powder group were higher than those in the mosapride group (P<0.05). There were no significant differences in hospital cost and length of hospital stay between the 2 groups.ConclusionThis study suggested that Tongfu powder for external application may improve gastrointestinal function for AP patients compared with mosapride.

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“…Scientific literature data suggest that splanchnic ischemia of various origins leads to increased levels of I-FABP and decreased levels of citrulline in the blood due to enterocyte damage and impaired intestinal barrier function [ 4 , 6 – 8 ].…”

Section: Discussionmentioning

confidence: 99%

The Intestinal Barrier Function and Intra-Abdominal Pressure Depend on Postoperative Analgesia Technique in Children with Appendicular Peritonitis

Перова-Шаронова

¹

,

Фесенко

²

2021

Critical Care Research and Practice

0

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Introduction. Peritonitis is one of the risk factors for the development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). The plasma citrulline and intestinal fatty acid-binding protein (I-FABP) are informative markers of intestinal barrier function. The aim of this study was to determine the correlation of the plasma citrulline and I-FABP with intra-abdominal pressure (IAP) and their relation to analgesia techniques in children suffering from appendicular peritonitis. Materials and Methods. 74 children operated for appendicular peritonitis were randomized into three groups of postoperative analgesia: “Opioids” (n = 25), intravenous morphine of 10 mcg/kg/h; “Lidocaine” (n = 23), intravenous lidocaine with initial bolus of 1.5 mg/kg and then infusion of 1.5 mg/kg/h; and “EA” (n = 26), epidurally 0.25% bupivacaine with initial bolus of 1 mg/kg and then infusion of 0.4 mg/kg/year. Retrospectively patients in each group were divided into the following subgroups: “without IAH” (n = 33), “IAH” (n = 27), and “ACS” (n = 14). We detected citrulline and I-FABP in plasma on day 1 (D1) and day 3 (D3) of hospital stay. Results. The patients without IAH on D1 presented significantly higher plasma citrulline (23.7 (16.0–31.3) nmol/ml) and lower I-FABP (76.9 (32.6–121.1) pg/ml) levels compared with patients in subgroup “IAH” (9.3 (7.3–11.3) nmol/ml and 226.0 (161.8–290.3) pg/ml, respectively) and subgroup “ACS” (6.9 (5.3–8.6) nmol/ml and 1011.7 (731.9–1291.5) pg/ml, respectively). The IAP had strong inverse correlation (rs = −0.74; p < 0.00001 ) with citrulline and positive strong correlation (rs = 0.73; p < 0.00001 ) with I-FABP. The citrulline in patients with IAH during three days postoperatively increased significantly in “Lidocaine” to 72% ( p = 0.01 ) and in “EA” to 138% ( p = 0.02 ), but it decreased to 13% ( p = 0.37 ) in “Opioids” group. In children with ACS, citrulline on D3 was significantly higher than that on D1 and increased in “Lidocaine” to 59% ( p = 0.05 ) and in “EA” to 134% ( p = 0.001 ), but in “Opioids” it decreased to 30% ( p = 0.48 ). The I-FABP in patients with IAH decreased to 12% in “Lidocaine” group ( p = 0.86 ) and to 75% in “EA” group ( p = 0.01 ), but it increased to 37% ( p = 0.57 ) in “Opioids” group. During observation period, I-FABP in patients with ACS decreased significantly in “Lidocaine” to 42% ( p = 0.05 ) and in “EA” to 96% ( p = 0.003 ), but it increased in “Opioids” to 63% ( p = 0.22 ). Conclusions. The IAP was inversely correlated with plasma citrulline and positively correlated with I-FABP in children with appendicular peritonitis. Epidural analgesia is the most protective for intestinal wall barrier function in patients at risk of IAH and ACS.

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“…Because of this, full caloric nutrition could not be provided to our hemodynamically unstable patients. The feeding of hemodynamically unstable patients is quite a difficult issue (19). Vasoconstriction was seen in the superior mesenteric artery in haemodynamic instability cases (20).…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Unstable Patients Fed Parenterally in Intensive Care Unit: Single Center Experience.

Elay¹,

Yardimci²,

Gündoğan³

2020

Eastern J Med

0

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The aim of this study was to determine the demographic and clinical characteristics of patients fed with total parenteral nutrition who were hemodynamically unstable in the ICU. This study was performed retrospectively in the medical intensive care unit of a university hospital. Information was obtained from the patients' files, the hospital electronic registry system and nutrition unit registration forms. This study included 51 patients. The mean age of the patients was 57 ± 19 years, of the patients 47% were male and 53% were female. When the reasons for total parenteral nutrition were evaluated, it was found that the most common causes of total parenteral nutrition were because of septic shock (47%) and gastrointestinal bleeding (23%). The daily caloric intake of the patients was 1,389 ± 286 kcal, and the target caloric value was 1,824 ± 256. The number of days with mechanical ventilation was 5 (median 0-42), the number of days stayed in the intensive care unit was 9 (median 1-125) and the number of days stayed in the hospital was 13 (median 1-155). The mortality rate of the patients was 71%. Serum albumin levels were found to be lower in patients who died than in those who lived, and these low albumin levels were statistically significant (p=0.015). In this study, it was seen that total parenteral nutrition was most commonly applied to the patients in a state of septic shock who had vasopressor support and to the patients who had gastrointestinal bleeding. In addition, it was determined that the target energy value could not be reached.

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Bowel Ischemia in ICU Patients: Diagnostic Value of I-FABP Depends on the Interval to the Triggering Event

Cited by 15 publications

References 17 publications

Efficacy and safety of Tongfu powder in acute pancreatitis patients with gastrointestinal dysfunction: a clinical trial

Efficacy and safety of Tongfu powder in acute pancreatitis patients with gastrointestinal dysfunction: a clinical trial

The Intestinal Barrier Function and Intra-Abdominal Pressure Depend on Postoperative Analgesia Technique in Children with Appendicular Peritonitis

Retrospective Evaluation of Unstable Patients Fed Parenterally in Intensive Care Unit: Single Center Experience.

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