TY - JOUR
T1 - Serological markers for human intestinal ischemia
T2 - A systematic review
AU - Derikx, Joep P.M.
AU - Schellekens, Dirk H.S.M.
AU - Acosta, Stefan
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Early and accurate diagnosis of intestinal ischemia is important in order to provide rapid and correct treatment and reduce morbidity and mortality rates. Clinical signs and symptoms are often unspecific. This systemic review sums up literature regarding human plasma biomarkers for acute mesenteric ischemia reported during the last ten years. Classic, general markers, including lactate, white cell count, base excess, show poor diagnostic accuracy for intestinal ischemia. Preliminary results for ischemia-modified albumin are promising, which is also true for the inflammatory marker procalcitonin. Best diagnostic accuracy is described for D-dimer, a-Glutathione S-transferase (a-GST) and Intestinal fatty acid binding protein (I-FABP), reflecting coagulation activity and mucosal damage respectively. Future studies should be directed at phase four questions (Do patients who undergo the diagnostic test fare better (in their ultimate health outcomes) than similar patients who do not?) for these markers and the identification of additional, novel plasma biomarkers signaling various types and stages of intestinal ischemia.
AB - Early and accurate diagnosis of intestinal ischemia is important in order to provide rapid and correct treatment and reduce morbidity and mortality rates. Clinical signs and symptoms are often unspecific. This systemic review sums up literature regarding human plasma biomarkers for acute mesenteric ischemia reported during the last ten years. Classic, general markers, including lactate, white cell count, base excess, show poor diagnostic accuracy for intestinal ischemia. Preliminary results for ischemia-modified albumin are promising, which is also true for the inflammatory marker procalcitonin. Best diagnostic accuracy is described for D-dimer, a-Glutathione S-transferase (a-GST) and Intestinal fatty acid binding protein (I-FABP), reflecting coagulation activity and mucosal damage respectively. Future studies should be directed at phase four questions (Do patients who undergo the diagnostic test fare better (in their ultimate health outcomes) than similar patients who do not?) for these markers and the identification of additional, novel plasma biomarkers signaling various types and stages of intestinal ischemia.
KW - diagnosis
KW - intestinal ischemia
KW - plasma biomarkers
UR - http://www.scopus.com/inward/record.url?scp=85013637500&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.bpg.2017.01.004
DO - https://doi.org/10.1016/j.bpg.2017.01.004
M3 - Review article
C2 - 28395790
SN - 1521-6918
VL - 31
SP - 69
EP - 74
JO - Best Practice and Research: Clinical Gastroenterology
JF - Best Practice and Research: Clinical Gastroenterology
IS - 1
ER -