title: Transition of intestinal fatty acid-binding protein on hypothermic circulatory arrest with cardiopulmonary bypass.
abstract: BACKGROUND
  Intestinal fatty acid-binding protein (I-FABP) is increasingly employed as a highly specific marker of intestinal necrosis. However, the value of this marker associated with cardiovascular surgery with hypothermic circulatory arrest is unclear. The aim of this study was to measure serum I-FABP levels and provide the transition of I-FABP levels with hypothermic circulatory arrest to help in the management of intestinal perfusion.
  
  
  METHODS
  From August 2011 to September 2013, 33 consecutive patients who had aortic arch surgery with hypothermic circulatory arrest or heart valve surgery performed were enrolled in the study. Twenty patients had aortic surgery with hypothermic (23-29°C) circulatory arrest and 13 patients had heart valve surgery with cardiopulmonary bypass (33°C).
  
  
  RESULTS
  I-FABP levels increased, both in patients undergoing aortic surgery with hypothermic circulatory arrest and heart valve surgery with cardiopulmonary bypass, reaching peak levels shortly after the administration of protamine. I-FABP levels in patients with aortic surgery were significantly higher with circulatory arrest. They reached peak levels immediately after recirculation and there was a significant drop at the end of surgery (p<0.001). I-FABP levels in heart valve surgery were gradually increased, with the highest at the administration of protamine; they gradually decreased. Peak I-FABP levels were significantly higher in patients undergoing aortic surgery with hypothermic circulatory arrest than in patients with heart valve surgery. However, no postoperative reperfusion injury occurred in the intestinal tract due to the use of hypothermic organ protection.
  
  
  CONCLUSIONS
  Plasma I-FABP monitoring could be a valuable method for finding an intestinal ischemia in patients with cardiovascular surgery.
authors.affiliation: 1 Clinical Engineering, Akashi Medical Center, Akashi, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kano
authors.affiliation: 2 Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: 2 Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: 2 Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: 2 Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006323:Heart Arrest / Q000097:blood; D006324:Heart Arrest, Induced / Q000009:adverse effects / Q000379:methods; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods; D007422:Intestines / Q000098:blood supply; D008297:Male; D011184:Postoperative Period; D011479:Protamines / Q000627:therapeutic use; D015427:Reperfusion Injury / Q000097:blood* / Q000209:etiology
chemical_list: D050556:Fatty Acid-Binding Proteins; D011479:Protamines
keywords: cardiopulmonary bypass; cardiovascular surgery; hypothermic circulatory arrest; intestinal fatty acid-binding protein; intestinal ischemia; total arch replacement