Background/Objectives: The aim of this study was to evaluate potential biomarkers of bacterial translocation (lipopolysaccharide-binding protein (LBP) and soluble CD14 subtype (sCD14-ST)) and intestinal wall damage (intestinal fatty acid binding protein (I-FABP), Zonulin, and regenerating islet-derived protein-3α (REG3α)) in patients with multiple organ dysfunction syndrome (MODS). Methods: The study involved 327 patients divided into two groups: Group 1 comprised 227 patients with MODS (main group), while Group 2 comprised 100 patients with identical pathologies but without MODS (control group). To examine these biomarkers in the blood, venous blood was taken in the control group on the day of admission to the hospital, in patients with MODS on the first day of MODS staging, and later on Days 3 and 7 of its development. Levels of these markers in blood serum were determined by enzyme-linked immunosorbent assays according to the manufacturers’ instructions. Results: In the control group, values of all the investigated markers were lower than in the group of MODS patients (p < 0.0001). In the main group, the mortality rate was 44.9% (n = 102). The values of sCD14-ST on Day 1 and of I-FABP and REG3α on Days 1 and 3 were higher in deceased MODS patients (p < 0.05), while LBP levels on Day 7 were conversely lower in the deceased patients (p = 0.006). SOFA and APACHE II scores were higher in the deceased patients (p < 0.0001). Conclusions: In MODS patients, the increased I-FABP, REG3α, and sCD14-ST but decreased LBP levels may indicate increased intestinal wall permeability and bacterial translocation, which may exacerbate the course of multiple organ dysfunction and increase the risk of mortality. Despite the limitations of this study, the studied potential biomarkers can be considered noteworthy candidates for identifying MODS patients at high risk of mortality.

The main aim of this study is to analyze changes in the lipopolysaccharide-binding protein (LBP) level in blood serum over time and assess it as a potential risk factor for the development of SIRS, infectious and inflammatory complications, organ dysfunction and mortality in patients operated on colorectal cancer (CRC). 90 CRC patients were divided into 2 groups: Group 1-50 patients operated on for CRC without acute bowel obstruction (ABO); Group 2-40 patients operated on for CRC with ABO. To determine LBP by ELISA method venous blood was taken 1 h before surgery and 72 h after it (3rd day). LBP level on the 3rd day after surgery was lower in CRC patients with SIRS, postoperative complications, organ dysfunction and in dead patients. With an LBP value on the 3rd day after surgery being at ≤821.95 ng/mL, the risk of SIRS occurrence is 3.5 times higher, that of the postoperative complications is 5.2 times higher and death is 12.9 times higher than with its higher level (OR 3.5, CI 1.46-8.4; OR 5.2, CI 1.80-15.12; OR 12.9, CI 1.54-108.21, respectively). If the LBP value on the 3rd day after surgery is ≤ 700.15 ng/mL, the risk of organ dysfunctions is 13.5 times higher than with its higher level (OR 13.5, CI 3.536-51.54). This study demonstrated that in the patients with CRC, the LBP can be used as a predictive criterion for the development of SIRS, postoperative infectious and inflammatory complications, organ dysfunction, and mortality.

AIM: The purpose of this study was to determine the level of significance of markers in the development of intra-abdominal hypertension in patients with acute surgical diseases of the abdominal cavity. METHODS: The authors surveyed 100 patients who were monitored at the Regional Clinical Hospital, Karaganda. The criterion for inclusion in the study was the informed consent of patients to participate in the study, the presence of acute surgical pathology, and the monitoring of intra-abdominal pressure over time. The exclusion criteria for patients from the study is the presence of sub and decompensation of associated diseases: trauma (hematoma of the bladder), bladder tumour and impaired integrity of the pelvic ring. The design of the study was by the legislation of the Republic of Kazakhstan, international ethical norms and normative documents of research organizations, approved by the ethics committee of the Karaganda State Medical University. RESULTS: According to the world scientific literature, there are 4 indicators that change their value in response to increases in pressure in the abdominal cavity: fibrinogen and prothrombin index (the main indicators of the coagulogram); marker of blood clots D-dimer; early marker of translocation of bacterial flora into the bloodstream sCD14 (presepsin). CONCLUSION: The authors concluded that the obtained data indicate that an increase in intra-abdominal pressure in acute surgical diseases of the abdominal cavity causes hypercoagulation and an increase in presepsin. Monitoring IAP with simultaneous measurement of the level of presepsin significantly improves the stratification of critical patients in need of emergency surgery.

Increased intestinal wall permeability and impaired barrier function in ICU patients are due to microcirculation disorders, ischemia and hypoxia of intestinal wall. As a result, bacteria and/or their endotoxins penetrate the damaged intestinal wall, enhance immune response and can lead to systemic inflammation, multiple organ dysfunction syndrome, sepsis and even death. This review is devoted to mechanisms of intestinal barrier disruption and the most effective serum biomarkers of intestinal wall damage: zonulin, intestinal fatty acid binding protein (I-FABP) and regenerating islet-derived 3-alpha (REG3α), citrulline. Despite various study limitations, these biomarkers are interesting candidates for identifying patients with high risk of complications and screening for timely intensive care measures. These approaches can reduce ICU-stay and mortality.

Introduction: The aim of this study was to evaluate the potential biomarkers of bacterial translocation: lipopolysaccharide‐binding protein (LBP) and soluble CD14 subtype (sCD14‐ST), and intestinal wall damage: intestinal fatty acid binding protein (I‐FABP), zonulin, and regenerating islet‐derived protein‐3α (REG3α), in the patients with multiple organ dysfunction syndrome (MODS).Methods: The study involved 78 patients over the age of 18 with MODS set according to the Sequential Organ Failure Assessment (SOFA) scale. Venous blood was sampled during diagnostics of MODS, on the 3rd and on the 7th day of its development. The sCD14‐ST, LBP, I‐FABP, REG3α, and zonulin in blood serum were determined by enzyme‐linked immunosorbent assay (ELISA).Results: Out of 78 patients with MODS, 43 patients survived (55.1%) and 35 patients died (44.9%). Levels of sCD14‐ST on Day 1, I‐FABP on Day 3, and REG3α on Days 3 and 7 and SOFA scores on Days 1, 3, and 7, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on Days 1, 3, and 7, and Modified Nutrition Risk in Critically Ill (mNUTRIC) scores on Days 1, 3, and 7 were statistically significantly higher in deceased patients (p < 0.05).Conclusion: In patients with MODS, an increase in sCD14‐ST, I‐FABP, and REG3α in blood serum can indicate the violation of intestinal barrier function and increased bacterial translocation, which ultimately may aggravate the severity of MODS and increase the risk of death. It is required to further study the factors leading to intestinal wall permeability disorders in order to screen for timely intensive care measures that can help reduce the stay of patients in the intensive care unit (ICU) as well as mortality.Trial Registration: ClinicalTrials.gov identifier: NCT06221293

Relevance: Preeclampsia is one of the most severe complications of pregnancy, characterized by the development of arterial hypertension and proteinuria after the 20th week of gestation. In recent years, increasing interest has been shown in the study of hematological parameters as potential biomarkers for early diagnosis and prediction of preeclampsia. Mean platelet volume (MPV) is an indicator reflecting the size and activity of platelets. An increase in MPV could indicate platelet activation and an inflammatory process. Mean corpuscular volume (MCV) characterizes the average length of red blood cells and could indicate various hematological disorders. The study aimed to assess the impact of MPV, MCV, and Hb levels on the risk of developing severe preeclampsia in pregnant women. Materials and Methods: The study included 85 pregnant women divided into two groups: 55 women with severe preeclampsia (Group 1) and 30 healthy pregnant women (Group 2). We conducted a multivariate analysis using logistic regression to assess the impact of these parameters on the risk of preeclampsia. We defined inclusion and exclusion criteria. The model’s accuracy was evaluated using ROC analysis. Results: The multivariate analysis revealed that elevated MCV and MPV values were associated with a reduced risk of developing severe preeclampsia, while elevated hemoglobin (Hb) levels were associated with an increased risk. Notably, the model demonstrated a high predictive accuracy, instilling confidence in the study's results with an AUC = 0.82. Conclusion: The study's findings suggest that MCV, MPV, and Hb parameters can significantly predict the risk of severe preeclampsia. Their potential use in clinical practice could offer hope for early diagnosis and prevention of this pregnancy complication, potentially improving outcomes for pregnant women.