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

J 2022

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

NOVOTNÝ, Tomáš, Robert STAFFA, Josef TOMANDL, Tomáš KŘIVKA, Ondřej SLABÝ et. al.

Základní údaje

Originální název

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

Autoři

NOVOTNÝ, Tomáš (203 Česká republika, garant, domácí), Robert STAFFA (203 Česká republika, domácí), Josef TOMANDL (203 Česká republika, domácí), Tomáš KŘIVKA (203 Česká republika, domácí), Ondřej SLABÝ (203 Česká republika, domácí), Luboš KUBÍČEK (203 Česká republika, domácí), Ernest BIROŠ (703 Slovensko, domácí), Marie TOMANDLOVÁ (203 Česká republika, domácí), Robert VLACHOVSKÝ (203 Česká republika, domácí), Jan ŠPONIAR (203 Česká republika, domácí), Lenka RADOVÁ (203 Česká republika, domácí) a Anna KONIECZNA (203 Česká republika, domácí)

Vydání

INTERNATIONAL JOURNAL OF SURGERY, AMSTERDAM, ELSEVIER, 2022, 1743-9191

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 15.300

Kód RIV

RIV/00216224:14110/22:00125315

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1016/j.ijsu.2021.106220

UT WoS

000743370200003

Klíčová slova anglicky

L-lactate; Aortic surgery; Abdominal aortic aneurysm; Aortoiliac occlusive disease; Intestinal ischemia

Štítky

14110119, 14110121, 14110512, 14110513, podil, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 31. 1. 2022 13:41, Mgr. Tereza Miškechová

Anotace

V originále

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.

Návaznosti

NV17-29701A, projekt VaV

Název: Ischémií modifikovaný albumin a cirkulující mikroRNA jako nové technologie k monitorování tkáňové ischémie po cévních rekonstrukcích na břišní aortě

Citovat

NOVOTNÝ, Tomáš, Robert STAFFA, Josef TOMANDL, Tomáš KŘIVKA, Ondřej SLABÝ, Luboš KUBÍČEK, Ernest BIROŠ, Marie TOMANDLOVÁ, Robert VLACHOVSKÝ, Jan ŠPONIAR, Lenka RADOVÁ a Anna KONIECZNA. L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study. INTERNATIONAL JOURNAL OF SURGERY. AMSTERDAM: ELSEVIER, 2022, roč. 98, February 2022, s. 1-8. ISSN 1743-9191. Dostupné z: https://dx.doi.org/10.1016/j.ijsu.2021.106220.

@article{1829385,
   author = {Novotný, Tomáš and Staffa, Robert and Tomandl, Josef and Křivka, Tomáš and Slabý, Ondřej and Kubíček, Luboš and Biroš, Ernest and Tomandlová, Marie and Vlachovský, Robert and Šponiar, Jan and Radová, Lenka and Konieczna, Anna},
   article_location = {AMSTERDAM},
   article_number = {February 2022},
   doi = {http://dx.doi.org/10.1016/j.ijsu.2021.106220},
   keywords = {L-lactate; Aortic surgery; Abdominal aortic aneurysm; Aortoiliac occlusive disease; Intestinal ischemia},
   language = {eng},
   issn = {1743-9191},
   journal = {INTERNATIONAL JOURNAL OF SURGERY},
   title = {L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study},
   url = {https://www.sciencedirect.com/science/article/pii/S1743919121003836?via%3Dihub},
   volume = {98},
   year = {2022}
}

TY  - JOUR
ID  - 1829385
AU  - Novotný, Tomáš - Staffa, Robert - Tomandl, Josef - Křivka, Tomáš - Slabý, Ondřej - Kubíček, Luboš - Biroš, Ernest - Tomandlová, Marie - Vlachovský, Robert - Šponiar, Jan - Radová, Lenka - Konieczna, Anna
PY  - 2022
TI  - L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study
JF  - INTERNATIONAL JOURNAL OF SURGERY
VL  - 98
IS  - February 2022
SP  - 1-8
EP  - 1-8
PB  - ELSEVIER
SN  - 17439191
KW  - L-lactate
KW  - Aortic surgery
KW  - Abdominal aortic aneurysm
KW  - Aortoiliac occlusive disease
KW  - Intestinal ischemia
UR  - https://www.sciencedirect.com/science/article/pii/S1743919121003836?via%3Dihub
N2  - 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.
ER  -

NOVOTNÝ, Tomáš, Robert STAFFA, Josef TOMANDL, Tomáš KŘIVKA, Ondřej SLABÝ, Luboš KUBÍČEK, Ernest BIROŠ, Marie TOMANDLOVÁ, Robert VLACHOVSKÝ, Jan ŠPONIAR, Lenka RADOVÁ a Anna KONIECZNA. L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study. \textit{INTERNATIONAL JOURNAL OF SURGERY}. AMSTERDAM: ELSEVIER, 2022, roč.~98, February 2022, s.~1-8. ISSN~1743-9191. Dostupné z: https://dx.doi.org/10.1016/j.ijsu.2021.106220.

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