Intestinal mucosal injury in critically III surgical patients: Preliminary observations

Gerald Gollin, Paul M. Zieg, Stephen M. Cohn, Joshua M. Lieberman, William H. Marks

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

This was a prospective study designed to evaluate the extent to which intestinal mucosal compromise occurs in adult critical care patients with and without systemic inflammatory response syndrome (SIRS) and to correlate the degree of intestinal injury with outcome. Ten patients from a university hospital surgical intensive care unit were identified who manifested SIRS at the time of admission to the intensive care unit. Five other critical care patients without SIRS were also evaluated. The Acute Physiology and Chronic Health Evaluation II score was determined. Intestinal mucosal viability was assessed by serial measurement of serum and urine iFABP intestinal fatty acid binding protein (iFABP), a sensitive and specific marker for mucosal injury. Outcome in terms of the development of multiorgan dysfunction syndrome, adult respiratory distress syndrome, and survival was determined. iFABP was detectable in the serum or urine in 8 out of 10 patients with SIRS. Among the 4 patients with detectable serum iFABP, 2 died and 1 developed severe adult respiratory distress syndrome. Nine of 11 patients without detectable serum iFABP recovered without major morbidity. iFABP was detectable in most patients with SIRS, suggesting that subclinical intestinal mucosal compromise is a frequent component of this syndrome. When iFABP was detectable, particularly in the serum, the prognosis was poor, even in the absence of SIRS, indicating that iFABP may be a relevant and independent predictor of outcome in critical care patients.

Original languageEnglish (US)
Pages (from-to)19-21
Number of pages3
JournalAmerican Surgeon
Volume65
Issue number1
StatePublished - Jan 1999
Externally publishedYes

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Fatty Acid-Binding Proteins
Systemic Inflammatory Response Syndrome
Wounds and Injuries
Critical Care
Adult Respiratory Distress Syndrome
Intensive Care Units
Blood Proteins
Serum
Urine
APACHE
Prospective Studies
Morbidity
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Gollin, G., Zieg, P. M., Cohn, S. M., Lieberman, J. M., & Marks, W. H. (1999). Intestinal mucosal injury in critically III surgical patients: Preliminary observations. American Surgeon, 65(1), 19-21.

Intestinal mucosal injury in critically III surgical patients : Preliminary observations. / Gollin, Gerald; Zieg, Paul M.; Cohn, Stephen M.; Lieberman, Joshua M.; Marks, William H.

In: American Surgeon, Vol. 65, No. 1, 01.1999, p. 19-21.

Research output: Contribution to journalArticle

Gollin, G, Zieg, PM, Cohn, SM, Lieberman, JM & Marks, WH 1999, 'Intestinal mucosal injury in critically III surgical patients: Preliminary observations', American Surgeon, vol. 65, no. 1, pp. 19-21.
Gollin G, Zieg PM, Cohn SM, Lieberman JM, Marks WH. Intestinal mucosal injury in critically III surgical patients: Preliminary observations. American Surgeon. 1999 Jan;65(1):19-21.
Gollin, Gerald ; Zieg, Paul M. ; Cohn, Stephen M. ; Lieberman, Joshua M. ; Marks, William H. / Intestinal mucosal injury in critically III surgical patients : Preliminary observations. In: American Surgeon. 1999 ; Vol. 65, No. 1. pp. 19-21.
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