Serological markers for human intestinal ischemia: A systematic review

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.