Features of prediction and diagnosis of intra-abdominal hypertension in cardiac surgery (clinical study)

Aim. To test the hypothesis that early detection of clinically significant patients with high risk of developing intra-abdominal hypertension in cardiac surgery may be based on an increase in the level of fatty acid-binding protein.

Material and Methods. Concentrations of fatty acid-binding protein (I-FABP) were measured in urine samples taken from 82 patients after cardiac surgery with cardiopulmonary bypass. The data were compared with clinical manifestations of the perioperative period, as well as changes in pH and lactate levels in arterial blood.

Results. Statistically significant differences were revealed between the study groups in the cases of increased intra-abdominal pressure, duration of ventilation, and the number of cases of intestinal failure. The level of I-FABP increased in the patients of both groups after removal of the aortic clamp in 2 hours, 12 hours, 24 hours after surgery. 

Conclusions. The I-FABP level can be a valuable marker for early detection of patients with the development intra-abdominal hypertension of after cardiac surgery.  The measurement of I-FABP can serve as a guideline not only for the identification of patients with intra-abdominal hypertension, but also for the initiation of therapeutic measures aimed at minimizing further deterioration of intestinal function.

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