I-FABP is a Novel Marker for the Detection of Intestinal Injury in Severely Injured Trauma Patients
- 360 Downloads
Intestinal injury is a rare injury in multiply traumatized patients, and its diagnosis remains difficult. Delayed diagnosis of an intestinal injury increases the risk of sepsis, multiple organ failure and mortality. The intestinal fatty acid-binding protein (I-FABP) is solely expressed in the intestine and is released extracellulary after tissue damage. This study evaluates the validity of I-FABP as an early biomarker to detect an abdominal injury and particularly an injury to the intestine.
Patients and Methods
Patients with an Abbreviated Injury Scale (AIS) score for abdominal body region (AIS abdomen) ≥3 were included in this study from 07/2006 to 12/2014. Of those, ten patients retrospectively had an intestinal injury (int. injury). According to the Injury Severity Score and the AIS abdomen, corresponding patients with an abdominal injury but without an intestinal injury (no int. injury) were included for matched-pair analysis. Twenty healthy volunteers served as controls. Plasma I-FABP levels were measured at admission to the emergency room and up to 10 days daily (d1–d10).
Median I-FABP levels were significantly higher in the “int. injury” group compared to the “no int. injury” group [2101.0 pg/ml (IQR = 1248.1–4117.8) vs. 351.4 pg/ml (IQR = 287.6–963.3), p < 0.05]. Furthermore, I-FABP levels of both groups were significantly higher compared to the control group [Ctrl: 127.2 pg/ml (IQR = 57.4–310.6), p < 0.05]. The time course of I-FABP levels showed a peak on the day of admission and a decline to the control levels in the further post-traumatic course. The development of complications such as single- or multi-organ failure, sepsis, acute respiratory distress syndrome, pneumonia and mortality was higher in the “int. injury” group; however, this difference was not statistically significant.
This study confirmed our previous observation that I-FABP might be used as a suitable early biomarker for the detection of abdominal injuries in general. In addition and more specific, I-FABP may be a useful and promising parameter in the diagnosis of intestinal injuries.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approval and consent to participate
Institutional Ethics Committee approval (167/05 and 176/07), in accordance with the Declaration of Helsinki and reported following the Strengthening the Reporting of Observational studies in Epidemiology, STROBE guidelines).
- 1.TraumaRegister DGU® (2014) TR-DGU der Sektion NIS. www.traumaregister.de
- 35.Voth M, Holzberger S, Auner B et al (2014) I-FABP and L-FABP are early markers for abdominal injury with limited prognostic value for secondary organ failures in the post-traumatic course. Clin Chem Lab Med 53:771–780Google Scholar
- 39.Barrington I (1998) The Abbreviated Injury Scale 1990 revision—update 1998. Association for the Advancement of Automotive MedicineGoogle Scholar
- 44.Dalhoff K, Abele M (2012) Epidemiology, diagnosis and treatment of adult patients with nosocomial pneumonia. S-3 Guideline of the German Society for Anaesthesiology and Intensive Care Medicine, the German Society for Infectious Diseases, the German Society for Hygiene and Microbiology, the German Respiratory Society and the Paul-Ehrlich-Society for Chemotherapy. Pneumologie 66:707–765CrossRefPubMedGoogle Scholar