L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F22%3A00075948" target="_blank" >RIV/00159816:_____/22:00075948 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/22:00125315

Result on the web

<a href="https://journals.lww.com/international-journal-of-surgery/Fulltext/2022/02000/l_lactate_kinetics_after_abdominal_aortic_surgery.13.aspx" target="_blank" >https://journals.lww.com/international-journal-of-surgery/Fulltext/2022/02000/l_lactate_kinetics_after_abdominal_aortic_surgery.13.aspx</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.ijsu.2021.106220" target="_blank" >10.1016/j.ijsu.2021.106220</a>

Result language

angličtina

Original language name

L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study

Original language description

Background: Postoperative intestinal ischemia is a severe complication in abdominal aortic surgery. Early diagnosis is needed for adequate and timely treatment. We studied the postoperative kinetics of L-lactate in vascular patients to assess its value as a marker for early postoperative intestinal ischemia detection. Material and methods: We performed a prospective non-randomized single-center observational cohort study in eighty elective patients, fifty operated on for abdominal aortic aneurysm (AAA) and thirty for aortoiliac occlusive disease (AIOD). Serum L-lactate was measured preoperatively, intraoperatively, and postoperatively at defined timepoints up to postoperative day 7. Intestinal ischemia was detected using MRI enterocolography. We have used univariate logistic regression and receiver operating characteristics curves for the evaluation of marker accuracy. Results: We recorded 6 cases of postoperative intestinal ischemia (7.5%), five non-transmural and one transmural. Two patients died because of this complication (mortality 33%). The comparison of AAA and AIOD cohorts showed a significant difference in L-lactate levels at one intraoperative timepoint, which was attributable to procedure differences. The only preoperative factor associated with higher L-lactate levels at some timepoints was chronic kidney disease. Patients suffering postoperative intestinal ischemia had elevated serum L-lactate levels at multiple timepoints. The most accurate timepoint for diagnosis was 24 h after the declamping of the vascular reconstruction (DC24H), the second was 10 min after declamping. Sensitivity, specificity, positive and negative predictive values at timepoint DC24H were 100%, 82%, 32%, and 100%, respectively. Conclusion: Serum L-lactate levels might help in the early detection of postoperative intestinal ischemia after aortic surgery if proper timepoints are used. Cutoff values need to be established in large-scale prospective studies.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30200 - Clinical medicine

Project

<a href="/en/project/NV17-29701A" target="_blank" >NV17-29701A: Ischemia modified albumin and circulating microRNAs as a new technology for monitoring of tissue ischemia following abdominal aortic vascular surgery</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2022

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

International Journal of Surgery

ISSN

1743-9191

e-ISSN

1743-9159

Volume of the periodical

98

Issue of the periodical within the volume

FEB 22

Country of publishing house

GB - UNITED KINGDOM

Number of pages

8

Pages from-to

106220

UT code for WoS article

000743370200003

EID of the result in the Scopus database

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