H Lange1, R Jäckel. 1. Surgical Department Hospital, Köping, Sweden.
Abstract
OBJECTIVE: To verify the diagnostic importance of the plasma lactate concentration in acute abdominal disease and to examine its role as a marker of mesenteric ischaemia. DESIGN: Prospective study. SETTING: Two departments of surgery, one in Sweden and one in Germany. SUBJECTS: 85 patients with acute abdominal symptoms. MAIN OUTCOME MEASURES: Correlation between the plasma lactate concentration before operation or (in the case of those not operated on) before the diagnosis was established, and the final diagnosis. RESULTS: Plasma lactate concentrations exceeded the reference range in all cases of mesenteric ischaemia (n = 20) and general bacterial peritonitis (n = 15) and in half of the 20 cases of intestinal obstruction. They were also raised in 3 of 10 cases of acute pancreatitis. CONCLUSIONS: A raised plasma lactate concentration is always a sign of an acute life-threatening condition, and usually indicates the need for an emergency operation. As a marker of mesenteric ischaemia its sensitivity was 100% and its specificity 42%. We conclude that a raised serum lactate concentration is the best marker of mesenteric ischaemia to date.
OBJECTIVE: To verify the diagnostic importance of the plasma lactate concentration in acute abdominal disease and to examine its role as a marker of mesenteric ischaemia. DESIGN: Prospective study. SETTING: Two departments of surgery, one in Sweden and one in Germany. SUBJECTS: 85 patients with acute abdominal symptoms. MAIN OUTCOME MEASURES: Correlation between the plasma lactate concentration before operation or (in the case of those not operated on) before the diagnosis was established, and the final diagnosis. RESULTS: Plasma lactate concentrations exceeded the reference range in all cases of mesenteric ischaemia (n = 20) and general bacterial peritonitis (n = 15) and in half of the 20 cases of intestinal obstruction. They were also raised in 3 of 10 cases of acute pancreatitis. CONCLUSIONS: A raised plasma lactate concentration is always a sign of an acute life-threatening condition, and usually indicates the need for an emergency operation. As a marker of mesenteric ischaemia its sensitivity was 100% and its specificity 42%. We conclude that a raised serum lactate concentration is the best marker of mesenteric ischaemia to date.
Authors: A Brillantino; F Iacobellis; A Renzi; R Nasti; L Saldamarco; M Grillo; L Romano; M Castriconi; A Cittadini; M De Palma; M Scaglione; N Di Martino; R Grassi; F Paladino Journal: Eur J Trauma Emerg Surg Date: 2017-06-13 Impact factor: 3.693
Authors: Lars W Andersen; Julie Mackenhauer; Jonathan C Roberts; Katherine M Berg; Michael N Cocchi; Michael W Donnino Journal: Mayo Clin Proc Date: 2013-10 Impact factor: 7.616