This journal is
indexed in Scopus
Year 2019 Vol. 27 No 6
GENERAL & SPECIAL SURGE
I.A. KRYVORUCHKO 1, V.V. BOYKO 1, 2, N.N. HONCHAROVA 1, I.A. TARABAN 1, O.V. ARSENYEV 3, JU.V. IVANOVA 1, 2, D.A. SMETSKOV 4, 5, A.G. DROZDOVA 5
EVALUATION OF INTESTINAL BARRIER BIOMARKER I-FABP AND SEVERITY OF PATIENTS IN ACUTE PANCREATITIS
Kharkiv National Medical University 1,
V.T. Zaytsev Institute of General and Emergency Surgery 2,
National University of Pharmacy 3,
Kharkiv Regional Clinical Hospital 4,
Kharkiv Medical Academy of Postgraduate Education 5, Kharkiv,
Objective. To determine the possibility of using I-FABP together with indicators of the abdominal cavity perfusion pressure to diagnose damages of digestive tract and to assess the acute pancreatitis severity.
Methods. A prospective, single-center controlled study was conducted in 58 patients. The dynamics of clinical and laboratory parameters, APACHE II score, AGI grade and parameters of the abdominal perfusion pressure in all patients were evaluated as well as I-FABP changes in 27 (46.6%) on admission and 48 hours after their complex treatment.
Results. The level of I-FABP in the serum after 48 hours increased by 69.8% on average, showed good accuracy for predicting the damage severity to the digestive tract after 48 hours compared with the initial level of AGI grade (area under the ROC curve 0.913) at the threshold value I-FABP 1350 pg/ml with a sensitivity of 0.95 and a specificity of 0.9. A good predictive value was found between the APACHE II score and the level of perfusion pressure in the abdomen when patients were admitted (area under the ROC-curve 0.889) and after 48 hours (the area under the ROC-curve 0.929) for complex treatment. It is established that the severity of the patient’s condition on the APACHE II scale can be predicted by the level of perfusion pressure when patients are admitted (threshold value 72.1 mm Hg, sensitivity 0.82, specificity 0.83) and after 48 hours of complex treatment (threshold 62 mm Hg, sensitivity 0.86, specificity 0.92).
Conclusions. Serum I-FABP is a valuable, convenient, objectively early predictor of the digestive tract damage in acute pancreatitis. The severity of patient’s condition can be predicted not only by using the APACHE II score, but also by evaluating the perfusion pressure in the abdominal cavity in the course of complex intensive therapy.
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Kharkiv, Nauki Ave., 4,
Kharkiv National Medical University,
Surgery Department ¹ 2.
Igor A. Kryvoruchko
Kryvoruchko Igor A., MD, Professor, Head of the Surgery Department ¹ 2, Kharkiv National Medical University, Kharkiv, Ukraine.
Boyko Valeriy V., Corresponding Member of NAMS of Ukraine, MD, Professor, Director of V.T. Zaytsev Institute of General and Emergency Surgery, Head of the Surgery Department ¹ 1, Kharkiv National Medical University, Kharkiv, Ukraine.
Honcharova Natalya N., MD, Associate Professor, Professor of the Surgery Department ¹ 2, Kharkiv National Medical University, Kharkiv, Ukraine.
Taraban Igor A., MD, Professor of the Surgery Department ¹ 1, Kharkiv National Medical University, Kharkiv, Ukraine.
Arsenyev Îleksandr V., PhD, Associate Professor of the Pharmacokinetics Department, National University of Pharmacy, Kharkiv, Ukraine.
Ivanova Julia V., MD, Leading Researcher, V.T. Zaytsev Institute of General and Emergency Surgery, Professor of the Surgery Department ¹1, Kharkiv National Medical University, Kharkiv, Ukraine.
Smetskov Dmytro A., PhD, Head of the Operative Unit of Kharkiv Regional Clinical Hospital, Associate Professor of the Department of Endoscopy and Surgery of Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine.
Drozdova Anastasiya G., Post-Graduate Student of the Surgery Department ¹ 2, Kharkiv National Medical University, Kharkiv, Ukraine.