{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:55:57Z","timestamp":1789178157938,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Critical Care Research and Practice"],"published-print":{"date-parts":[[2021,8,7]]},"abstract":"<jats:p>Introduction. Peritonitis is one of the risk factors for the development of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). The plasma citrulline and intestinal fatty acid-binding protein (I-FABP) are informative markers of intestinal barrier function. The aim of this study was to determine the correlation of the plasma citrulline and I-FABP with intra-abdominal pressure (IAP) and their relation to analgesia techniques in children suffering from appendicular peritonitis. Materials and Methods. 74 children operated for appendicular peritonitis were randomized into three groups of postoperative analgesia: \u201cOpioids\u201d (n\u2009=\u200925), intravenous morphine of 10\u2009mcg\/kg\/h; \u201cLidocaine\u201d (n\u2009=\u200923), intravenous lidocaine with initial bolus of 1.5\u2009mg\/kg and then infusion of 1.5\u2009mg\/kg\/h; and \u201cEA\u201d (n\u2009=\u200926), epidurally 0.25% bupivacaine with initial bolus of 1\u2009mg\/kg and then infusion of 0.4\u2009mg\/kg\/year. Retrospectively patients in each group were divided into the following subgroups: \u201cwithout IAH\u201d (n\u2009=\u200933), \u201cIAH\u201d (n\u2009=\u200927), and \u201cACS\u201d (n\u2009=\u200914). We detected citrulline and I-FABP in plasma on day 1 (D1) and day 3 (D3) of hospital stay. Results. The patients without IAH on D1 presented significantly higher plasma citrulline (23.7 (16.0\u201331.3) nmol\/ml) and lower I-FABP (76.9 (32.6\u2013121.1)\u2009pg\/ml) levels compared with patients in subgroup \u201cIAH\u201d (9.3 (7.3\u201311.3)\u2009nmol\/ml and 226.0 (161.8\u2013290.3)\u2009pg\/ml, respectively) and subgroup \u201cACS\u201d (6.9 (5.3\u20138.6)\u2009nmol\/ml and 1011.7 (731.9\u20131291.5)\u2009pg\/ml, respectively). The IAP had strong inverse correlation (rs\u2009=\u2009\u22120.74; <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.00001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>) with citrulline and positive strong correlation (rs\u2009=\u20090.73; <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.00001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>) with I-FABP. The citrulline in patients with IAH during three days postoperatively increased significantly in \u201cLidocaine\u201d to 72% (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.01<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>) and in \u201cEA\u201d to 138% (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.02<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>), but it decreased to 13% (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>p<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.37<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>) in \u201cOpioids\u201d group. In children with ACS, citrulline on D3 was significantly higher than that on D1 and increased in \u201cLidocaine\u201d to 59% (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>p<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.05<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>) and in \u201cEA\u201d to 134% (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>p<\/m:mi>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>0.001<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>), but in \u201cOpioids\u201d it decreased to 30% (<jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>p<\/o:mi>\n                        <o:mo>=<\/o:mo>\n                        <o:mn>0.48<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>). The I-FABP in patients with IAH decreased to 12% in \u201cLidocaine\u201d group (<jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>p<\/q:mi>\n                        <q:mo>=<\/q:mo>\n                        <q:mn>0.86<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>) and to 75% in \u201cEA\u201d group (<jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mi>p<\/s:mi>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.01<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>), but it increased to 37% (<jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mi>p<\/u:mi>\n                        <u:mo>=<\/u:mo>\n                        <u:mn>0.57<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula>) in \u201cOpioids\u201d group. During observation period, I-FABP in patients with ACS decreased significantly in \u201cLidocaine\u201d to 42% (<jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mi>p<\/w:mi>\n                        <w:mo>=<\/w:mo>\n                        <w:mn>0.05<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>) and in \u201cEA\u201d to 96% (<jats:inline-formula>\n                     <y:math xmlns:y=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\">\n                        <y:mi>p<\/y:mi>\n                        <y:mo>=<\/y:mo>\n                        <y:mn>0.003<\/y:mn>\n                     <\/y:math>\n                  <\/jats:inline-formula>), but it increased in \u201cOpioids\u201d to 63% (<jats:inline-formula>\n                     <ab:math xmlns:ab=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M14\">\n                        <ab:mi>p<\/ab:mi>\n                        <ab:mo>=<\/ab:mo>\n                        <ab:mn>0.22<\/ab:mn>\n                     <\/ab:math>\n                  <\/jats:inline-formula>). Conclusions. The IAP was inversely correlated with plasma citrulline and positively correlated with I-FABP in children with appendicular peritonitis. Epidural analgesia is the most protective for intestinal wall barrier function in patients at risk of IAH and ACS.<\/jats:p>","DOI":"10.1155\/2021\/6650361","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T19:50:09Z","timestamp":1628538609000},"page":"1-8","source":"Crossref","is-referenced-by-count":1,"title":["The Intestinal Barrier Function and Intra-Abdominal Pressure Depend on Postoperative Analgesia Technique in Children with Appendicular Peritonitis"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6701-236X","authenticated-orcid":true,"given":"Valentyna","family":"Perova-Sharonova","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Lviv Regional Pediatric Hospital, Lviv 79000, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7788-2457","authenticated-orcid":true,"given":"Ulbolhan","family":"Fesenko","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Danylo Halytsky Lviv National Medical University, Lviv 79010, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2906-z"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.5603\/ait.a2015.0026"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1053\/j.mpsur.2006.06.002"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/mcc.0000000000000283"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2017.06.004"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/2795176"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1515\/cclm-2014-0354"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1186\/cc7301"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.08.023"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2012.07.004"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.10.015"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1179\/acb.2008.63.2.005"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.11.013"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199902000-00034"}],"container-title":["Critical Care Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/ccrp\/2021\/6650361.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ccrp\/2021\/6650361.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/ccrp\/2021\/6650361.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T19:50:12Z","timestamp":1628538612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/ccrp\/2021\/6650361\/"}},"subtitle":[],"editor":[{"given":"Mohammad-Salar","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,8,7]]},"references-count":14,"alternative-id":["6650361","6650361"],"URL":"https:\/\/doi.org\/10.1155\/2021\/6650361","relation":{},"ISSN":["2090-1313","2090-1305"],"issn-type":[{"value":"2090-1313","type":"electronic"},{"value":"2090-1305","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8,7]]}}}