Document Detail


Rectal lactate levels in endoluminal microdialysate during routine coronary surgery.
MedLine Citation:
PMID:  17300302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this prospective study was to determine the feasibility of intestinal endoluminal microdialysis as a new method for clinical monitoring of the adequacy of splanchnic perfusion in the large bowel. A microdialysis catheter for continuous lactate, glycerol, glucose and pyruvate measurements attached to a tonometric catheter was placed into the lumen of the recto-sigmoid junction prior to surgery in 13 patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). Lactate was also measured in blood and muscle. CPB was associated with a 10-fold increase in luminal lactate from 0.16 (0.01) to 1.67 (0.38) mmol x l(-1) (p < 0.001). Muscular lactate increased from baseline levels 1.20 (0.21) to 1.77 (0.36) mmol x l(-1) during CPB (p = 0.01), but the muscular lactate-pyruvate ratio remained unchanged. Arterial lactate increased only slightly from 0.9 (0.05) to 1.1 (0.06) mmol x l(-1) (p = 0.027) during CPB. Increased lactate concentrations in the large bowel during CPB are suggestive of local lactate production consistent with impaired oxygen delivery. Intestinal endoluminal microdialysis is a potential clinically applicable method for monitoring intestinal metabolism. Combined with tonometry, microdialysis provides the opportunity to monitor both circulation and metabolism in the rectal mucosa.
Authors:
E Solligård; A Wahba; E Skogvoll; R Stenseth; J E Grønbech; P Aadahl
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  62     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-15     Completed Date:  2007-04-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  250-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, St Olav University Hospital, Norwegian University of Science and Technology, N-7006 Trondheim, Norway. erik.solligard@ntnu.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure
Cardiopulmonary Bypass
Coronary Artery Bypass*
Feasibility Studies
Humans
Intestinal Mucosa / blood supply,  metabolism
Lactic Acid / blood,  metabolism*
Male
Manometry / methods
Microdialysis / methods*
Middle Aged
Monitoring, Intraoperative / methods*
Oxygen Consumption
Postoperative Period
Prospective Studies
Rectum / blood supply,  metabolism*
Splanchnic Circulation
Vascular Resistance
Chemical
Reg. No./Substance:
50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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