Serological markers of acute mesenteric ischemia after cardiac surgery

• Belov D.V.
• Abramovskikh O.S.
• Fokin A.A.
• Sumerkina V.A.
• Pykhova L.R.

Abstract

Background. Acute mesenteric ischemia in cardiac surgery, with a relatively rare occurrence, is accompanied by high mortality, reaching 90%.

Aim. We set the task to analyze the diagnostic value (specificity and sensitivity) of Intestinal fatty acid-binding protein (I-FABP), lipopolysaccharide-binding protein (LBP), endothelin-1, D-lactam in the diagnosis of acute mesenteric ischemia after heart surgery.

Material and methods. A prospective randomized study of potential biomarkers of acute mesenteric ischemia was carried out in 77 patients aged 40 to 94 years [54 men (72.9%) and 23 women (27.0%)] on the basis of the Federal Center for Cardiovascular Surgery of the Ministry of Health of Russia (Chelyabinsk) and medical organizations of the Chelyabinsk Region from 2021 to 2022.

Results. In intestinal paresis, the only statistically significant predictor on the 1st day was LBP with the threshold value of 44.7 ng/ml. With the development of destructive changes, the maximum diagnostic effectiveness was demonstrated by D-lactam and the intestinal form of fatty acid binding protein, an increase in the concentration of which above 0.54 mmol/l and 720 pg/ml, respectively, indicates the risk of developing acute mesenteric ischemia with intestinal necrosis.

Conclusion. Determination of the threshold values of I-FABP and D-lactam concentration can be recommended as a screening test in the laboratory diagnosis of acute mesenteric ischemia.

Keywords:acute mesenteric ischemia; biochemical markers; intestinal fatty acid-binding protein; lipopolysaccharide-binding protein; endothelin-1; D-lactam

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