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Intestinal fatty acid binding protein as a predictor for intra-abdominal pressure-related complications in patients
Steven G Strang1, Quirine L M Habes2, Ben Van der Hoven3
1Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Insights
Intestinal fatty acid binding protein (I-FABP) levels do not reliably predict intra-abdominal hypertension complications in critically ill patients. This study found no significant diagnostic value for I-FABP in identifying patients at risk for abdominal compartment syndrome or organ failure.
Area of Science:
- Critical Care Medicine
- Gastroenterology
- Nephrology
Background:
- Critically ill patients face risks of intra-abdominal hypertension (IAH), leading to organ failure, abdominal compartment syndrome (ACS), and mortality.
- Early identification of IAH-associated complications is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate the utility of urinary and serum intestinal fatty acid binding protein (I-FABP) as early biomarkers for predicting IAH-related complications.
- To determine if I-FABP levels can identify patients at risk for developing abdominal compartment syndrome (ACS) or new organ failure.
Main Methods:
- A prospective observational study involving 198 adult patients in mixed medical-surgical ICUs with at least two IAH risk factors.
- Intra-abdominal pressure (IAP), urinary I-FABP, and serum I-FABP were measured every six hours for 72 hours.
- Correlation analysis was performed between I-FABP levels, IAP, and the development of ACS or organ failure.
Main Results:
- Fifteen patients (8%) developed ACS, and 74 (37%) developed new organ failure.
- A positive correlation was observed between I-FABP levels and IAP.
- While patients who developed ACS had higher median baseline urinary I-FABP levels, neither urinary nor serum I-FABP significantly predicted the risk of developing new organ failure or ACS.
Conclusions:
- Intestinal fatty acid binding protein (I-FABP) demonstrated no significant diagnostic value in identifying individual critically ill patients at risk for IAH-related complications.
- The study could not establish I-FABP as a reliable early marker for predicting abdominal compartment syndrome or organ failure in this patient population.
Purpose:
Critically ill patients are at risk for intra-abdominal hypertension (IAH) and related complications such as organ failure, abdominal compartment syndrome (ACS), and death. This study aimed to determine the value of urinary and serum intestinal fatty acid binding protein (I-FABP) levels as early marker for IAH-associated complications.
Methods:
A prospective observational study was conducted in two academic institutional mixed medical-surgical ICUs in the Netherlands. Adult patients admitted to the ICU with two or more risk factors for IAH (198) were included. Urinary and serum I-FABP and intra-abdominal pressure (IAP) were measured every six hours during 72 h.
Results:
Fifteen (8%) patients developed ACS and 74 (37%) developed new organ failure. I-FABP and IAP were positively correlated. Patients who developed ACS had higher median baseline levels of urinary I-FABP (235(P25-P75 85-1747)μg/g creat) than patients with IAH who did not develop ACS (87(P25-P75 33-246)μg/g, p = 0.037). With an odds ratio of 1.00, neither urinary nor serum I-FABP indicated increased risk for developing new organ failure or ACS.
Conclusions:
A relevant diagnostic value of I-FABP levels for identifying individual patients at risk for intra-abdominal pressure related complications could not be demonstrated.
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