Serum D(−)-lactate levels as an aid to diagnosing acute intestinal ischemia
No serum marker has consistently proved helpful in diagnosing early acute mesenteric ischemia. D(−)-lactate is a product of bacterial metabolism and was found to be elevated in peripheral blood in a rat model of intestinal ischemia. We conducted a prospective study to evaluate preoperative D(−)-lact...
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| Veröffentlicht in: | The American journal of surgery 1994-06, Vol.167 (6), p.575-578 |
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| creator | Murray, Michael J. Gonze, Mark D. Nowak, Lisa R. Cobb, Charles F. |
| description | No serum marker has consistently proved helpful in diagnosing early acute mesenteric ischemia. D(−)-lactate is a product of bacterial metabolism and was found to be elevated in peripheral blood in a rat model of intestinal ischemia. We conducted a prospective study to evaluate preoperative D(−)-lactate levels in 31 patients undergoing laparotomy for acute abdominal emergencies, including suspected acute mesenteric ischemia. The serum was deproteinated and D(−)-lactate concentration was determined by a spectrophotometric assay. A control group was composed of patients with a benign abdominal examination who were operated on for central venous line placement. We found significant elevations in D(−)-lactate levels in patients with mesenteric ischemia compared with controls (
P < 0.00005), as well as in patients with other forms of abdominal catastrophes (
P < 0.00005) and with bowel obstruction (
P < 0.0005). Sensitivity and specificity were 90% and 87%, respectively. The negative predictive value was 96%, and the positive predictive value was 70%. We have found that D(−)-lactate serum levels can aid in diagnosing acute mesenteric ischemia. |
| doi_str_mv | 10.1016/0002-9610(94)90101-5 |
| format | Article |
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P < 0.00005), as well as in patients with other forms of abdominal catastrophes (
P < 0.00005) and with bowel obstruction (
P < 0.0005). Sensitivity and specificity were 90% and 87%, respectively. The negative predictive value was 96%, and the positive predictive value was 70%. We have found that D(−)-lactate serum levels can aid in diagnosing acute mesenteric ischemia.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/0002-9610(94)90101-5</identifier><identifier>PMID: 8209931</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abdomen ; Acute Disease ; Biological and medical sciences ; Clinical Enzyme Tests ; Digestive System Diseases - diagnosis ; Disasters ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Intestine ; Intestines - blood supply ; Ischemia ; Ischemia - diagnosis ; Lactates - blood ; Lactic Acid ; Medical sciences ; Mesentery - blood supply ; Metabolism ; Other diseases. Semiology ; Peripheral blood ; Predictive Value of Tests ; Prospective Studies ; Sensitivity and Specificity ; Serum levels ; Spectrophotometry ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><ispartof>The American journal of surgery, 1994-06, Vol.167 (6), p.575-578</ispartof><rights>1994</rights><rights>1994 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jun 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-47b79cecd7c9c23a4be137f1135edca0ccf3d0afe0dd3deecffacbb553dd98773</citedby><cites>FETCH-LOGICAL-c414t-47b79cecd7c9c23a4be137f1135edca0ccf3d0afe0dd3deecffacbb553dd98773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/0002961094901015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4256207$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8209931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murray, Michael J.</creatorcontrib><creatorcontrib>Gonze, Mark D.</creatorcontrib><creatorcontrib>Nowak, Lisa R.</creatorcontrib><creatorcontrib>Cobb, Charles F.</creatorcontrib><title>Serum D(−)-lactate levels as an aid to diagnosing acute intestinal ischemia</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>No serum marker has consistently proved helpful in diagnosing early acute mesenteric ischemia. D(−)-lactate is a product of bacterial metabolism and was found to be elevated in peripheral blood in a rat model of intestinal ischemia. We conducted a prospective study to evaluate preoperative D(−)-lactate levels in 31 patients undergoing laparotomy for acute abdominal emergencies, including suspected acute mesenteric ischemia. The serum was deproteinated and D(−)-lactate concentration was determined by a spectrophotometric assay. A control group was composed of patients with a benign abdominal examination who were operated on for central venous line placement. We found significant elevations in D(−)-lactate levels in patients with mesenteric ischemia compared with controls (
P < 0.00005), as well as in patients with other forms of abdominal catastrophes (
P < 0.00005) and with bowel obstruction (
P < 0.0005). Sensitivity and specificity were 90% and 87%, respectively. The negative predictive value was 96%, and the positive predictive value was 70%. We have found that D(−)-lactate serum levels can aid in diagnosing acute mesenteric ischemia.</description><subject>Abdomen</subject><subject>Acute Disease</subject><subject>Biological and medical sciences</subject><subject>Clinical Enzyme Tests</subject><subject>Digestive System Diseases - diagnosis</subject><subject>Disasters</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Intestine</subject><subject>Intestines - blood supply</subject><subject>Ischemia</subject><subject>Ischemia - diagnosis</subject><subject>Lactates - blood</subject><subject>Lactic Acid</subject><subject>Medical sciences</subject><subject>Mesentery - blood supply</subject><subject>Metabolism</subject><subject>Other diseases. Semiology</subject><subject>Peripheral blood</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Serum levels</subject><subject>Spectrophotometry</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kN9qFTEQh4Mo9bT6BgoLSmkvVpNNstncCFKtChUv1OswO5mtKfunTXYLfQOvfcQ-iVnP4Vx4UQiEzHwz_PIx9kLwN4KL-i3nvCptLfiJVaeW51qpH7GNaIwtRdPIx2yzR56yw5Su8lMIJQ_YQVNxa6XYsK_fKS5D8eHk_vef07IHnGGmoqdb6lMB-YwFBF_MU-EDXI5TCuNlAbhkKIwzpTmM0Bch4S8aAjxjTzroEz3f3Ufs5_nHH2efy4tvn76cvb8oUQk1l8q0xiKhN2ixkqBaEtJ0QkhNHoEjdtJz6Ih7Lz0Rdh1g22otvbeNMfKIHW_3XsfpZskp3JAjUN_DSNOSnKm1tLrSGXz1H3g1LTFHTq5qlFHa1mql1JbCOKUUqXPXMQwQ75zgbnXtVpFuFemscv9cu3Xs5W750g7k90M7ubn_eteHhNB3EUYMaY-pStcVXz_zbotl5XQbKLqEgUYkHyLh7PwUHs7xF4IBmyo</recordid><startdate>19940601</startdate><enddate>19940601</enddate><creator>Murray, Michael J.</creator><creator>Gonze, Mark D.</creator><creator>Nowak, Lisa R.</creator><creator>Cobb, Charles F.</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19940601</creationdate><title>Serum D(−)-lactate levels as an aid to diagnosing acute intestinal ischemia</title><author>Murray, Michael J. ; Gonze, Mark D. ; Nowak, Lisa R. ; Cobb, Charles F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-47b79cecd7c9c23a4be137f1135edca0ccf3d0afe0dd3deecffacbb553dd98773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Abdomen</topic><topic>Acute Disease</topic><topic>Biological and medical sciences</topic><topic>Clinical Enzyme Tests</topic><topic>Digestive System Diseases - diagnosis</topic><topic>Disasters</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Intestine</topic><topic>Intestines - blood supply</topic><topic>Ischemia</topic><topic>Ischemia - diagnosis</topic><topic>Lactates - blood</topic><topic>Lactic Acid</topic><topic>Medical sciences</topic><topic>Mesentery - blood supply</topic><topic>Metabolism</topic><topic>Other diseases. Semiology</topic><topic>Peripheral blood</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Serum levels</topic><topic>Spectrophotometry</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Murray, Michael J.</creatorcontrib><creatorcontrib>Gonze, Mark D.</creatorcontrib><creatorcontrib>Nowak, Lisa R.</creatorcontrib><creatorcontrib>Cobb, Charles F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Murray, Michael J.</au><au>Gonze, Mark D.</au><au>Nowak, Lisa R.</au><au>Cobb, Charles F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum D(−)-lactate levels as an aid to diagnosing acute intestinal ischemia</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>1994-06-01</date><risdate>1994</risdate><volume>167</volume><issue>6</issue><spage>575</spage><epage>578</epage><pages>575-578</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>No serum marker has consistently proved helpful in diagnosing early acute mesenteric ischemia. D(−)-lactate is a product of bacterial metabolism and was found to be elevated in peripheral blood in a rat model of intestinal ischemia. We conducted a prospective study to evaluate preoperative D(−)-lactate levels in 31 patients undergoing laparotomy for acute abdominal emergencies, including suspected acute mesenteric ischemia. The serum was deproteinated and D(−)-lactate concentration was determined by a spectrophotometric assay. A control group was composed of patients with a benign abdominal examination who were operated on for central venous line placement. We found significant elevations in D(−)-lactate levels in patients with mesenteric ischemia compared with controls (
P < 0.00005), as well as in patients with other forms of abdominal catastrophes (
P < 0.00005) and with bowel obstruction (
P < 0.0005). Sensitivity and specificity were 90% and 87%, respectively. The negative predictive value was 96%, and the positive predictive value was 70%. We have found that D(−)-lactate serum levels can aid in diagnosing acute mesenteric ischemia.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8209931</pmid><doi>10.1016/0002-9610(94)90101-5</doi><tpages>4</tpages></addata></record> |
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| ispartof | The American journal of surgery, 1994-06, Vol.167 (6), p.575-578 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Abdomen Acute Disease Biological and medical sciences Clinical Enzyme Tests Digestive System Diseases - diagnosis Disasters Gastroenterology. Liver. Pancreas. Abdomen Humans Intestine Intestines - blood supply Ischemia Ischemia - diagnosis Lactates - blood Lactic Acid Medical sciences Mesentery - blood supply Metabolism Other diseases. Semiology Peripheral blood Predictive Value of Tests Prospective Studies Sensitivity and Specificity Serum levels Spectrophotometry Stomach. Duodenum. Small intestine. Colon. Rectum. Anus |
| title | Serum D(−)-lactate levels as an aid to diagnosing acute intestinal ischemia |
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