Engen, L.A.H. van (2012) The role of gut wall integrity on the development of SIRS and MOF after trauma: a pilot study. thesis, Medicine.
Full text available on request.Abstract
Objective The aim of this study is to analyze the relation between I-FABP (as a marker fir gut wall integrity), SIRS and Multiple Organ Failure after trauma. In this study the relation between loss of gut wall integrity and the development of a systemic inflammation reaction after trauma is determined. I-FABP levels are assessed as a possible marker for SIRS and MOF. Methods In this prospective study all patients >18 year and admitted to the UMCG as an A-trauma are included. I-FABP is analyzed in blood samples taken upon arrival in the ER, and subsequently 3h, 6h, 9h, 12h, 1 day, 2 day up to a maximum of seven days after trauma. When a patient is operated, only data from the period before surgery are used to avoid influence of a “second hit” on I-FABP levels. The SIRS criteria are noted at every sample moment. SOFA scores were calculated for every day in the ICU blood samples were taken. Results I-FABP (pg/ml) increases rapidly after trauma and is more than halved after one day: median (range) ER 2627 (506-1282489) and 1 day 1103 (294-30104). I-FABP (ER) correlates significantly with SI (correlation: 0,382, p<0,01), MAP (correlation: -0,320, p<0,01) and EMTRAS (correlation: 0,442, p<0,01). I-FABP (3h) predicts the occurrence of SIRS in the following days after trauma (sensitivity of 64%, specificity of 71%) and a SOFA ≥8 (sensitivity of 83%, specificity of 100%)on the first day in the ICU. I-FABP does not correlate with SIRS and MOF after the first day post trauma. Conclusion I-FABP (pg/ml) increases within the first hour after trauma to decrease on the same day. Severity of the injury and shock contribute to release of I-FABP into the circulation. Loss of gut wall integrity after early trauma contributes to the development of a systemic response on the following days after trauma and Multiple Organ Failure on the first day in the ICU. I-FABP levels in the following days after trauma do not mark a possible pro-inflammatory state of the patient
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Hulscher JBF, MD and Paediatric surgeon and University Medical Centre Groningen, Department of Surgery |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:53 |
| Last Modified: | 25 Jun 2020 10:53 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1395 |
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