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.

Basic information

Original name

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

Authors

NOVOTNÝ, Tomáš (203 Czech Republic, guarantor, belonging to the institution), Robert STAFFA (203 Czech Republic, belonging to the institution), Josef TOMANDL (203 Czech Republic, belonging to the institution), Tomáš KŘIVKA (203 Czech Republic, belonging to the institution), Ondřej SLABÝ (203 Czech Republic, belonging to the institution), Luboš KUBÍČEK (203 Czech Republic, belonging to the institution), Ernest BIROŠ (703 Slovakia, belonging to the institution), Marie TOMANDLOVÁ (203 Czech Republic, belonging to the institution), Robert VLACHOVSKÝ (203 Czech Republic, belonging to the institution), Jan ŠPONIAR (203 Czech Republic, belonging to the institution), Lenka RADOVÁ (203 Czech Republic, belonging to the institution) and Anna KONIECZNA (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 15.300

RIV identification code

RIV/00216224:14110/22:00125315

Organization unit

Faculty of Medicine

DOI

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

UT WoS

000743370200003

Keywords in English

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

Abstract

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.

Links

NV17-29701A, research and development project

Name: 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 and Anna KONIECZNA. L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study. INTERNATIONAL JOURNAL OF SURGERY. AMSTERDAM: ELSEVIER, 2022, vol. 98, February 2022, p. 1-8. ISSN 1743-9191. Available from: 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 and Anna KONIECZNA. L-lactate kinetics after abdominal aortic surgery and intestinal ischemia An observational cohort study. \textit{INTERNATIONAL JOURNAL OF SURGERY}. AMSTERDAM: ELSEVIER, 2022, vol.~98, February 2022, p.~1-8. ISSN~1743-9191. Available from: https://dx.doi.org/10.1016/j.ijsu.2021.106220.

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