Clinical significance of intestinal type fatty acid binding protein in patients undergoing coronary artery bypass surgery

Camkiran, Aynur; Dönmez, Aslı; Aldemir, Derya; Işgüzar, Rauf Agah; Gültekin, Bahadır

doi:10.5152/akd.2011.139

Cited by 5 publications

(11 citation statements)

References 19 publications

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“…Results of critical appraisal are shown in Table 1 . After critical appraisal, three papers were excluded from the final analysis [ 49 , 50 , 52 ]. Camkiran studied plasma I-FABP levels in 35 patients undergoing elective coronary artery bypass; however, none of the patients developed AMI.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis

2017

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Laparotomy remains the gold standard for diagnosis of acute mesenteric ischemia (AMI), but is often unhelpful or too late due to non-specific clinical and radiological signs. This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of the novel serological biomarkers intestinal fatty acid-binding protein (I-FABP), α-glutathione S-transferase (α-GST), D-lactate, ischemia modified albumin (IMA), and citrulline to detect AMI. A systematic search of electronic databases was performed to identify all published diagnostic accuracy studies on I-FABP, α-GST, D-lactate, IMA, and citrulline. Articles were selected based on pre-defined inclusion and exclusion criteria. Risk of bias and applicability were assessed. Two-by-two contingency tables were constructed to calculate accuracy standards. Summary estimates were computed using random-effects models. The search yielded 1925 papers, 21 were included in the final analysis. Pooled sensitivity and specificity for investigated biomarkers were: I-FABP (Uden); 79.0 (95% CI 66.5-88.5) and 91.3

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Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis

2017

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“…I-FABP is a small (15-kD) protein within the cytoplasm of mature enterocytes located at the tips of the villi of the small bowel [ 9 ]. The concentration is undetectable in normal situations [ 10 – 13 ]. Ischemic damage of the villi leads to release of this protein into the circulation.…”

Section: Introductionmentioning

confidence: 99%

Can serum L-lactate, D-lactate, creatine kinase and I-FABP be used as diagnostic markers in critically ill patients suspected for bowel ischemia

Voort

Wester

et al. 2014

BMC Anesthesiol

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BackgroundThe prognostic value of biochemical tests in critically ill patients with multiple organ failure and suspected bowel ischemia is unknown.MethodsIn a prospective observational cohort study intensive care patients were included when the attending intensivist considered intestinal ischemia in the diagnostic workup at any time during intensive care stay. Patients were only included once. When enrolment was ended each patient was classified as ‘proven intestinal ischemia’, ‘ischemia likely’, ‘ischemia unlikely’ or ‘no intestinal ischemia’. Proven intestinal ischemia was defined as the gross disturbance of blood flow in the bowel, regardless of extent and grade. Classification was based on reports from the operating surgeon, pathology department, endoscopy reports and CT-scan. Lactate dehydrogenase (LDH), creatine kinase (CK), alanine aminotransferase (ALAT), L-lactate were available for the attending physician. D-lactate and intestinal fatty acid binding protein (I-FABP) were analysed later in a batch. I-FABP was only measured in patients with proven ischemia or no ischemia.ResultsFor 44 of the 120 included patients definite diagnostic studies were available. 23/44 patients (52%) had proven intestinal ischemia as confirmed by surgery, colonoscopy, autopsy and/or histopathological findings. LDH in these patients was 285 U/l (217–785) vs 287 U/l (189–836) in no-ischemia; p = 0.72. CK was 226 U/l in patients with proven ischemia (126–2145) vs 347 U/l (50–1427), p = 0.88. ALAT was 53 U/l (18–300) vs 34 U/l (14–34), p-0,56. D-lactate 0.41 mmol/l (0.11-0.75) vs 0.56 mmol/l (0.27-0.77), p = 0.46. L-lactate 3.5 mmol/l (2.2-8.4) vs 2.6 mmol/l (1.7-3.9), p = 0.09. I-FABP 2872 pg/ml (229–4340) vs 1020 pg/ml (239–5324), p = 0.98. Patient groups proven and likely ischemia together compared to unlikely and no-ischemia together showed significant higher L-lactate (p = 0.001) and higher D-lactate (p = 0.003).ConclusionsMeasurement of LDH, CK, and ALAT did not discriminate critically ill patients with proven intestinal ischemia from those with definite diagnosis no-ischemia. However, L-lactate and D-lactate levels were higher in patients with proven or likely ischemia and need further study just as I-FABP.

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“…Previous studies showed promising results with I-FABP in patients with acute abdomen [10, 11, 15] or abdominal injury [12] and also as monitoring parameter during and shortly after major surgery [13, 14, 16]. We conducted this prospective observational study to evaluate the diagnostic value of I-FABP in ICU patients with suspected mesenteric ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…I-FABP is abundant only at the tips of the villi of bowel mucosa and rapidly released into the circulation in case of severe mucosal ischemia [13, 14, 17, 18]. It may be possible that I-FABP is not released when the ischemia of the bowel wall progresses and the mucosa does not recover, leading to false negative I-FABP test results.…”

Section: Discussionmentioning

confidence: 99%

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

Ludewig

Jarbouh

Ardelt

et al. 2017

Gastroenterology Research and Practice

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Background Intestinal fatty acid-binding protein (I-FABP) has been shown to be of high diagnostic value in patients with acute mesenteric ischemia. Whether these results can be reproduced in critically ill patients on the ICU was to be investigated. Materials and Methods I-FABP was measured in serum and urine of 43 critically ill patients in ICU when mesenteric ischemia was suspected. Bowel ischemia was confirmed in 21 patients (group 1). 22 patients who survived at least seven days without confirmation of ischemia were assigned to group 2. I-FABP levels were compared between the groups, and interval from the event that has triggered ischemia to I-FABP measurement was recorded. Results For the identification of patients with mesenteric ischemia, sensitivity, specificity, and area under the curve (AUC) for serum and urine I-FABP were 33.3%, 95.5%, and 0.565 and 81.3%, 70.0%, and 0.694, respectively. I-FABP measurements performed within 12 to 48 h after the event that triggered ischemia showed a sensitivity, specificity, and AUC for serum and urine of 75%, 100%, and 0.853 and 100%, 73.3%, and 0.856, respectively. Conclusions In ICU patients, one single I-FABP measurement at the time of clinical suspicion failed to reliably detect or exclude mesenteric ischemia. A higher diagnostic value of I-FABP was only confirmed in the early stages of mesenteric ischemia. I-FABP may be used most appropriately in perioperative monitoring.

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Clinical significance of intestinal type fatty acid binding protein in patients undergoing coronary artery bypass surgery

Cited by 5 publications

References 19 publications

Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis

Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis

Can serum L-lactate, D-lactate, creatine kinase and I-FABP be used as diagnostic markers in critically ill patients suspected for bowel ischemia

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

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