Skip to main content Skip to main navigation menu Skip to site footer

Comparation of intestinal fatty acid binding protein (I-FABP) level between pre- and post-surgery and its associated determinants in patients with microscopic otorhinolaryngology surgeries

  • Yuda Atmajaya ,
  • Mohammad Satriyo Wibowo ,
  • Prananda Surya Airlangga ,
  • Maulydia ,
  • Prihatma Kriswidyatomo ,
  • Muhtarum Yusuf ,
  • Budi Utomo ,


Introduction: Intestinal fatty acid binding protein (I-FABP) is expected could be used as predictor of tissue hypoperfusion. This study sought to compare the level of I-FABP between pre- and post-surgery and its associated determinants in patients with otorhinolaryngology surgeries using general anesthesia with controlled hypotension (CH) technique.

Methods: We did a cross-sectional study was conducted among patients that underwent elective surgeries at Dr. Soetomo in Surabaya, Indonesia. Those who underwent surgeries using general anesthesia with CH technique were recruited in the study. I-FABP levels were measured using ELISA 1 hour before the surgery and 30 minutes after general anesthesia ended. Fisher's exact test and Mann-Whitney test were used to determine the determinants associated with changes of I-FABP level between pre- and post-surgery.

Results: A total of 31 patients who underwent the surgeries with general anesthesia and CH technique were included in this study. The median of I-FABP level pre- and post-surgery was 0.639 ng/mL to 0.779 ng/mL, respectively suggesting there was a significant increase of I-FABP level after the CH technique (p<0.001). Gender and ASA score did not associate with I-FABP level changes pre- and post-surgery with p=0.333 and 0.060, respectively. Age, BMI did not associate with changes of I-FABP level between pre- and post-surgery (p=0.747 and p=0.051, respectively). Surgery duration, anesthesia duration, systolic, diastolic and MAP all also had no association with changes of the I-FABP level with p>0.05.

Conclusion: The levels of I-FABP increased significantly in post-surgery in patients with otorhinolaryngology surgeries using general anesthesia with CH. Further studies are warranted to confirm this result with bigger sample size.


  1. Sabrina AM, Maulydia, Perdana RF, Fitriati M. Airway Foreign Bodies in Patients that Underwent Bronchoscopies with General Anesthesia in Dr. Soetomo General Academic Hospital Surabaya. Indones J Anesthesiol Reanim [Internet]. 2022;4(2):72–9. Available from:
  2. Salinding A, Wahyudi W, Pradipta A. Anesthesia and Analgesia Management Profile for Airway Surgeries at Dr. Soetomo General Academic Hospital Surabaya. Indones J Anesthesiol Reanim [Internet]. 2022;4(2):98–106. Available from:
  3. Butterworth JF, Mackey DC, Wasnick JD. Morgan & Mikhail's clinical anesthesiology: McGraw-Hill New York; 2013.
  4. Miller RD, Pardo MC. Preface [Internet]. Basics of Anesthesia. Elsevier; 2011. p. ix. Available from:
  5. Gibson APA, Medina MM. The use of the controlled hypotension in otorhinolaryngology surgeries. Acta Médica Grupo Angeles. 2010;8(3):148-54.
  6. Degoute C-S. Controlled Hypotension. Drugs [Internet]. 2007;67(7):1053–76. Available from:
  7. Lindop MJ. Complications And Morbidity Of Controlled Hypotension. Br J Anaesth [Internet]. 1975;47(7):799–803. Available from:
  8. Kohli HS, Bhaskaran MC, Muthukumar T, Thennarasu K, Sud K, Jha V, et al. Treatment-related acute renal failure in the elderly: a hospital-based prospective study. Nephrol Dial Transplant [Internet]. 2000;15(2):212–7. Available from:
  9. Yun SH, Kim JH, Kim HJ. Comparison of the hemodynamic effects of nitroprusside and remifentanil for controlled hypotension during endoscopic sinus surgery. J Anesth [Internet]. 2014;29(1):35–9. Available from:
  10. Varol A, Basa S, Ozturk S. The role of controlled hypotension upon transfusion requirement during maxillary downfracture in double-jaw surgery. J Cranio-Maxillofacial Surg [Internet]. 2010;38(5):345–9. Available from:
  11. Kanda T, Fujii H, Fujita M, Sakai Y, Ono T, Hatakeyama K. Intestinal fatty acid binding protein is available for diagnosis of intestinal ischaemia: immunochemical analysis of two patients with ischaemic intestinal diseases. Gut [Internet]. 1995 May;36(5):788–91. Available from:
  12. Sarengat R, Islam MS, Ardhi MS. Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19. Narra J [Internet]. 2021;1(3). Available from:
  13. Mahmud AA, Anu UH, Foysal KA, Hasan M, Sazib SM, Ragib AA, et al. Elevated serum malondialdehyde (MDA), insulin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid-stimulating hormone (TSH), and reduced antioxidant vitamins in polycystic ovarian syndrome patients. Narra J [Internet]. 2022;2(1). Available from:
  14. Zahra Z, Ramadhani CT, Mamfaluti T, Pamungkas SR, Firdausa S. Association between depression and HbA1c levels in the elderly population with type 2 diabetes mellitus during COVID-19 pandemic. Narra J [Internet]. 2022;2(1). Available from:
  15. Lorena C, Hamzah H, Maulydia M. Accuracy Comparison of Endotracheal Tube (ETT) Placement Using Chula Formula With Manubrium Sternal Joint (MSJ) Formula. Indones J Anesthesiol Reanim [Internet]. 2021;3(2):54. Available from:
  16. Mudatsir M, Fajar JK, Wulandari L, Soegiarto G, Ilmawan M, Purnamasari Y, et al. Predictors of COVID-19 severity: a systematic review and meta-analysis. F1000Research [Internet]. 2020 Sep 9;9:1107. Available from:
  17. Harapan H, Fajar JK, Supriono S, Soegiarto G, Wulandari L, Seratin F, et al. The prevalence, predictors and outcomes of acute liver injury among patients with COVID-19: A systematic review and meta-analysis. Rev Med Virol [Internet]. 2021/10/13. 2022 May;32(3):e2304–e2304. Available from:
  18. Andrianto, Al-Farabi MJ, Nugraha RA, Marsudi BA, Azmi Y. Biomarkers of endothelial dysfunction and outcomes in coronavirus disease 2019 (COVID-19) patients: A systematic review and meta-analysis. Microvasc Res [Internet]. 2021/07/15. 2021 Nov;138:104224. Available from:
  19. Pramana Witarto A, Samarta Witarto B, Er Putra AJ, Pramudito SL, Rosyid AN. Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19 Lung Injury: A Systematic Review and Meta-Analysis. Iran Biomed J [Internet]. 2021 Nov 1;25(6):381–9. Available from:
  20. Derikx JPM, Vreugdenhil ACE, Van den Neucker AM, Grootjans J, van Bijnen AA, Damoiseaux JGMC, et al. A Pilot Study on the Noninvasive Evaluation of Intestinal Damage in Celiac Disease Using I-FABP and L-FABP. J Clin Gastroenterol [Internet]. 2009;43(8):727–33. Available from:
  21. Grootjans J, Hodin CM, de Haan J, Derikx JPM, Rouschop KMA, Verheyen FK, et al. Level of Activation of the Unfolded Protein Response Correlates With Paneth Cell Apoptosis in Human Small Intestine Exposed to Ischemia/Reperfusion. Gastroenterology [Internet]. 2011;140(2):529-539.e3. Available from:
  22. Fink MP, Delude RL. Epithelial Barrier Dysfunction: A Unifying Theme to Explain the Pathogenesis of Multiple Organ Dysfunction at the Cellular Level. Crit Care Clin [Internet]. 2005;21(2):177–96. Available from:
  23. Thuijls G, Derikx JPM, Haan J-J de, Grootjans J, Bruïne A de, Masclee AAM, et al. Urine-based Detection of Intestinal Tight Junction Loss. J Clin Gastroenterol [Internet]. 2010;44(1):e14–9. Available from:
  24. Berkes J, Viswanathan VK, Savkovic SD, Hecht G. Intestinal epithelial responses to enteric pathogens: effects on the tight junction barrier, ion transport, and inflammation. Gut [Internet]. 2003 Mar;52(3):439–51. Available from:
  25. Marchiando AM, Shen L, Graham WV, Edelblum KL, Duckworth CA, Guan Y, et al. The epithelial barrier is maintained by in vivo tight junction expansion during pathologic intestinal epithelial shedding. Gastroenterology [Internet]. 2011/01/13. 2011 Apr;140(4):1208-1218.e12182. Available from:
  26. Pelsers MMAL, Namiot Z, Kisielewski W, Namiot A, Januszkiewicz M, Hermens WT, et al. Intestinal-type and liver-type fatty acid-binding protein in the intestine. Tissue distribution and clinical utility. Clin Biochem [Internet]. 2003;36(7):529–35. Available from:
  27. Robinson JW, Mirkovitch V. The recovery of function and microcirculation in small intestinal loops following ischaemia. Gut [Internet]. 1972 Oct;13(10):784–9. Available from:
  28. Lieberman JM, Sacchettini J, Marks C, Marks WH. Human intestinal fatty acid binding protein: Report of an assay with studies in normal volunteers and intestinal ischemia. Surgery [Internet]. 1997;121(3):335–42. Available from:
  29. Hermens WT. Mechanisms of Protein Release from Injured Heart Muscle [Internet]. Developments in Cardiovascular Medicine. Springer Netherlands; 1998. p. 85–98. Available from:
  30. Timmermans K, Sir Ö, Kox M, Vaneker M, de Jong C, Gerretsen J, et al. Circulating iFABP Levels as a Marker of Intestinal Damage in Trauma Patients. Shock [Internet]. 2015;43(2):117–20. Available from:
  31. Relja B, Szermutzky M, Henrich D, Maier M, De Haan J-J, Lubbers T, et al. Intestinal-FABP and Liver-FABP: Novel Markers for Severe Abdominal Injury. Acad Emerg Med [Internet]. 2010;17(7):729–35. Available from:
  32. Lackey AI, Chen T, Zhou YX, Bottasso Arias NM, Doran JM, Zacharisen SM, et al. Mechanisms underlying reduced weight gain in intestinal fatty acid-binding protein (IFABP) null mice. Am J Physiol Gastrointest Liver Physiol [Internet]. 2020/01/06. 2020 Mar 1;318(3):G518–30. Available from:
  33. Guedj K, Uzzan M, Soudan D, Trichet C, Nicoletti A, Weiss E, et al. I-FABP is decreased in COVID-19 patients, independently of the prognosis. PLoS One [Internet]. 2021 Apr 15;16(4):e0249799–e0249799. Available from:

How to Cite

Atmajaya, Y., Wibowo, M. S. ., Airlangga, P. S., Maulydia, Kriswidyatomo, P. ., Yusuf, M. ., & Utomo, B. . (2022). Comparation of intestinal fatty acid binding protein (I-FABP) level between pre- and post-surgery and its associated determinants in patients with microscopic otorhinolaryngology surgeries. Bali Medical Journal, 11(3), 1855–1859.




Search Panel