ORGAN FAILURE, INFECTION, AND THE SYSTEMIC INFLAMMATORY RESPONSE SYNDROME ARE ASSOCIATED WITH ELEVATED LEVELS OF URINARY INTESTINAL FATTY-ACID-BINDING PROTEIN - STUDY OF 100 CONSECUTIVE PATIENTS IN A SURGICAL INTENSIVE-CARE UNIT

Background: Intestinal mucosal ischemia and subsequent barrier dysfunc tion have been related to the development of organ dysfunction and dea th in the critically ill. We hypothesized that urine concentrations of intestinal fatty acid binding protein (IFABP), a sensitive marker of intestinal ischemia, might predict the development of the systemic inf lammatory response syndrome (SIRS) and organ dysfunction, Methods: One hundred consecutive critically ill patients were prospectively studie d for the development of infectious complications, organ dysfunction, and SIRS, Urine was collected daily for measurement of IFABP, Results: A total of 58 males and 42 females (mean age, 56 gears; range, 16-85 years) were studied. Of these 100 patients, 40 patients developed comp lications and 5 patients developed SIRS, IFABP was significantly eleva ted in all patients with SIRS, and IFABP levels peaked an average of 1 .4 days (range, 0-7 days) before the diagnosis of SIRS. Conclusion: El evated concentrations of urine IFABP correlated with the clinical deve lopment of SIRS, Studies to assess the utility of IFABP as a predictor of organ dysfunction and SIRS in the critically ill are warranted.