Collange O, Veber B, Tamion F, Lavoine A, Plissonnier D, Dureuil B. [Interest of D-lactate as a colic hypoperfusion marker during aortic abdominal aneurysm surgery].
ACTA ACUST UNITED AC 2006;
25:940-6. [PMID:
16891085 DOI:
10.1016/j.annfar.2006.03.040]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2004] [Accepted: 03/10/2006] [Indexed: 12/22/2022]
Abstract
OBJECTIVE
D-lactate is the dextrogyre form of the lactate usually measured in intensive care. Its bacterial origin should make it a marker of translocation during gut ischemia. The aim was to test D-lactate as a postoperative marker of colic hypoperfusion measured during aortic surgery.
STUDY DESIGN
Prospective observational cohort study.
PATIENTS AND MEASUREMENTS
Patients operated for abdominal aortic aneurysm. Two groups were stratified on inferior mesenteric arterial residual pressure (IMArP) measured during the surgery: Colic hypoperfusion during surgery (CHs) group: patients with an IMArP < 40 mmHg.
CONTROL GROUP
patients with an IMArP > or = 40 mmHg. Baseline data such as age, duration of aortic clamping and severity score (IGS II) were collected. The D-lactate was measured in postoperative at admission time in ICU and then daily. D-lactate(max) defined the maximum value of D-lactate for one patient.
MAIN RESULTS
Twenty-nine patients were included, 23 in the control group and 6 in the CHs group. Groups were comparable at baseline. D-lactate(max) was significantly higher in the CHs group (median: 0.13 mmol/l; min-max: 0.03-0.9 mmol/l) than in the control group (0.03; 0-0.26 mmol/l, p=0.007).
CONCLUSION
D-lactate could be postoperative marker of colic hypoperfusion measured during surgery for abdominal aortic aneurysm.
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