Early detection of mesenteric ischemia in critically ill patients following cardiac surgery
Abstract Mesenteric ischemia (Me-Is) is a severe complication with high mortality after cardiac surgery. We examined whether intestinal fatty acid binding protein (I-FABP) might serve as a biomarker for early detection of Me-Is following cardiac surgery. Between March 2022 and December 2023, we cond...
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Nature Portfolio
2025-07-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-10534-9 |
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| author | Zulfugar T. Taghiyev Sophia Gunkel Lili-Marie Beier Carina Leweling Kevin M. Sadowski Borros M. Arneth Chrysanthi Skevaki Johannes Kalder Paula R. Keschenau Andreas Böning |
| author_facet | Zulfugar T. Taghiyev Sophia Gunkel Lili-Marie Beier Carina Leweling Kevin M. Sadowski Borros M. Arneth Chrysanthi Skevaki Johannes Kalder Paula R. Keschenau Andreas Böning |
| author_sort | Zulfugar T. Taghiyev |
| collection | DOAJ |
| description | Abstract Mesenteric ischemia (Me-Is) is a severe complication with high mortality after cardiac surgery. We examined whether intestinal fatty acid binding protein (I-FABP) might serve as a biomarker for early detection of Me-Is following cardiac surgery. Between March 2022 and December 2023, we conducted a prospective observational study of 500 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass. Blood samples were obtained at five time points perioperatively. An immunoassay was used to determine I-FABP levels in 48 individuals at high risk of Me-Is due to lactic acidosis > 4 mmol/L and interleukin (IL)-6 > 600 pg/mL: 6 patients with confirmed Me-Is (cMe-Is), 18 patients with suspected Me-Is (sMe-Is), and 24 patients a in propensity score-matched control group. Of the 48 patients, 62.5% initially had mild gastrointestinal dysfunction (AGI ≤ II), but 80% of them progressed to AGI III or higher, with 25% reaching AGI IV. Baseline serum I-FABP values were similar between the three groups. The six patients with cMe-Is showed significantly elevated serum I-FABP levels from ICU admission to 36 h post-admission, peaking at 207,411.46 pg/mL. ROC analysis identified serum I-FABP as the most accurate predictor of Me-Is, with an AUC of 0.973 at 36 h post-ICU admission (95% CI [0.764–0.997], p < 0.001) and an optimal cut-off of > 1421 pg/mL, with 100% sensitivity. In contrast, IL-6 and lactate levels showed no significant differences between groups. Serum I-FABP showed high accuracy in predicting Me-Is after cardiac surgery, outperforming IL-6 and lactate. Our data suggest that I-FABP may have value as a biomarker for early detection of Me-Is after cardiac surgery and help to improve patient management. |
| format | Article |
| id | doaj-art-bdc11a8842b34c45b7ab79c74293fd7f |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-bdc11a8842b34c45b7ab79c74293fd7f2025-08-20T03:42:28ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-10534-9Early detection of mesenteric ischemia in critically ill patients following cardiac surgeryZulfugar T. Taghiyev0Sophia Gunkel1Lili-Marie Beier2Carina Leweling3Kevin M. Sadowski4Borros M. Arneth5Chrysanthi Skevaki6Johannes Kalder7Paula R. Keschenau8Andreas Böning9Department of Cardiovascular Surgery, Justus Liebig UniversityDepartment of Cardiovascular Surgery, Justus Liebig UniversityDepartment of Cardiovascular Surgery, Justus Liebig UniversityDepartment of Cardiovascular Surgery, Justus Liebig UniversityDepartment of Cardiovascular Surgery, Justus Liebig UniversityInstitute of Laboratory Medicine, German Center of Lung Research, Universities of Giessen and Marburg Lung Center, Phillips University MarburgInstitute of Laboratory Medicine, German Center of Lung Research, Universities of Giessen and Marburg Lung Center, Phillips University MarburgDepartment of Cardiovascular Surgery, Justus Liebig UniversityDepartment of Cardiovascular Surgery, Justus Liebig UniversityDepartment of Cardiovascular Surgery, Justus Liebig UniversityAbstract Mesenteric ischemia (Me-Is) is a severe complication with high mortality after cardiac surgery. We examined whether intestinal fatty acid binding protein (I-FABP) might serve as a biomarker for early detection of Me-Is following cardiac surgery. Between March 2022 and December 2023, we conducted a prospective observational study of 500 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass. Blood samples were obtained at five time points perioperatively. An immunoassay was used to determine I-FABP levels in 48 individuals at high risk of Me-Is due to lactic acidosis > 4 mmol/L and interleukin (IL)-6 > 600 pg/mL: 6 patients with confirmed Me-Is (cMe-Is), 18 patients with suspected Me-Is (sMe-Is), and 24 patients a in propensity score-matched control group. Of the 48 patients, 62.5% initially had mild gastrointestinal dysfunction (AGI ≤ II), but 80% of them progressed to AGI III or higher, with 25% reaching AGI IV. Baseline serum I-FABP values were similar between the three groups. The six patients with cMe-Is showed significantly elevated serum I-FABP levels from ICU admission to 36 h post-admission, peaking at 207,411.46 pg/mL. ROC analysis identified serum I-FABP as the most accurate predictor of Me-Is, with an AUC of 0.973 at 36 h post-ICU admission (95% CI [0.764–0.997], p < 0.001) and an optimal cut-off of > 1421 pg/mL, with 100% sensitivity. In contrast, IL-6 and lactate levels showed no significant differences between groups. Serum I-FABP showed high accuracy in predicting Me-Is after cardiac surgery, outperforming IL-6 and lactate. Our data suggest that I-FABP may have value as a biomarker for early detection of Me-Is after cardiac surgery and help to improve patient management.https://doi.org/10.1038/s41598-025-10534-9Intestinal fatty acid-binding protein (I-FABP)Cardiac surgeryMesenteric ischemiaAcute gastrointestinal injury (AGI) |
| spellingShingle | Zulfugar T. Taghiyev Sophia Gunkel Lili-Marie Beier Carina Leweling Kevin M. Sadowski Borros M. Arneth Chrysanthi Skevaki Johannes Kalder Paula R. Keschenau Andreas Böning Early detection of mesenteric ischemia in critically ill patients following cardiac surgery Scientific Reports Intestinal fatty acid-binding protein (I-FABP) Cardiac surgery Mesenteric ischemia Acute gastrointestinal injury (AGI) |
| title | Early detection of mesenteric ischemia in critically ill patients following cardiac surgery |
| title_full | Early detection of mesenteric ischemia in critically ill patients following cardiac surgery |
| title_fullStr | Early detection of mesenteric ischemia in critically ill patients following cardiac surgery |
| title_full_unstemmed | Early detection of mesenteric ischemia in critically ill patients following cardiac surgery |
| title_short | Early detection of mesenteric ischemia in critically ill patients following cardiac surgery |
| title_sort | early detection of mesenteric ischemia in critically ill patients following cardiac surgery |
| topic | Intestinal fatty acid-binding protein (I-FABP) Cardiac surgery Mesenteric ischemia Acute gastrointestinal injury (AGI) |
| url | https://doi.org/10.1038/s41598-025-10534-9 |
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