gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie, 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

25. - 28.10.2011, Berlin

L-FABP as novel serum marker for intra-abdominal injury?

Meeting Abstract

  • D.R. Nellensteijn - UMCG, Traumachirurgie, Groningen, Netherlands
  • W.J.J. de Jong - UMCG, Traumachirurgie, Groningen, Netherlands
  • E. Heineman - UMCG, Kinderchirurgie, Groningen, Netherlands
  • H.J. ten Duis - UMCG, Traumachirurgie, Groningen, Netherlands
  • K. Wendt - UMCG, Traumachirurgie, Groningen, Netherlands
  • J. Hulscher - UMCG, Kinderchirurgie, Groningen, Netherlands

Deutscher Kongress für Orthopädie und Unfallchirurgie. 75. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 97. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 52. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 25.-28.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocGR12-815

DOI: 10.3205/11dkou460, URN: urn:nbn:de:0183-11dkou4602

Veröffentlicht: 18. Oktober 2011

© 2011 Nellensteijn et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Questionnaire: When looking for novel serum markers for intra-abdominal injury, Liver Fatty Acid Binding Protein (L-FABP) is suggested to be of value. It is present in liver, small and large bowel, pancreas and kidney. Injury and/or hypoperfusion of these organs results in a release of L-FABP into the systemic circulation. L-FABP is rapidly excreted by the kidney. Little is known about L-FABP kinetics in trauma patients. Aim of the present study is to determine kinetics of L-FABP in multi-trauma patients. Secondary aim is to gain insight into the relation of L-FABP levels with the severity of injury, specifically the presence of intra-abdominal injury.

Methods: All patients >18 years of age admitted to the emergency room as so-called A-trauma's (highest level of urgency) were included. Patients were assessed for age, sex, injury and mortality.

To determine the kinetics of L-FABP, blood samples were obtained upon arrival (T0) in the emergency room, and subsequently three (T3), six (T6), nine (T9), twelve (T12) and 24 (T24) hours after trauma. Sampling was ceased upon surgery or discharge from hospital. The presence of intra-abdominal injury was defined by the presence of intra-abdominal injury on ultrasound, CT scan or by intraoperative findings.

Subsequently the group was divided into those with and without abdominal injury and these groups were compared. Serum L-FABP levels were measured using a commercially available ELISA (Figure 1 [Fig. 1]).

Results and Conclusions: Between March and July 2010, 62 consecutive patients were admitted. Six patients were excluded for reasons such as denial of consent, logistics or death upon arrival, leaving fifty-six patients for analysis.

There were 46 males and 10 females, median age 46 yrs (18-82). Median ISS was 17 (1-75). Five patients sustained one or more abdominal injuries: liver (4), spleen (2), and duodenum (1). Mortality was 25%.

The characteristics of the abdominally injured versus the non-abdominally injured groups were respectively: age 48 (38-82) vs. 45 (18-79) p=0.35; sex 4M 1F vs. 42M 9F; ISS 49 (17-59) vs. 16 (1-75) p=0.007; mortality 40% vs. 24% (p=0,42).

The abdominally injured group had higher L-FABP levels at T0, T3 and T6 compared to the non-abdominally injured group (fig1). This equalises within nine hours after trauma.

There is a difference in L-FABP levels between abdominally injured patients and non-abdominally injured patients. This rise in L-FABP occurs within one hour post-trauma, to decrease rapidly within nine hours. This suggests that L-FABP is a potential valuable early marker for intra-abdominal injury.