D-lactate is not a reliable marker of gut ischemia-reperfusion in a rat model of supraceliac aortic clamping.
OBJECTIVE
D-lactate is the dextrorotatory form of L-lactate. L-lactate is the isomer routinely tested in clinical practice to assess cell hypoxemia. D-lactate has been recently proposed as a specific marker of gut ischemia-reperfusion (IR), particularly after surgery for ruptured aortic aneurysms. We sought to assess D-lactate as a reliable marker of gut IR in a rat model of supraceliac aortic clamping.


METHODS
Prospective, randomized trial.


METHODS
Animal research center.


METHODS
Male Wistar rats.


METHODS
After general anesthesia, rats were randomized into two groups (n = 8 in each). The IR group underwent a laparotomy, aortic clamping for 40 mins, and 1 hr of reperfusion. The control group underwent the same procedure, except for aortic clamping.


RESULTS
The following variables were tested after 1 hr of reperfusion (IR group) or after the equivalent time (control group): 1) tissue and cell insult via ileum morphometry and electron microscopy, serum glutamic transaminases (serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase), pH, and L-lactate; 2) systemic inflammatory response via tumor necrosis factor-alpha; and 3) D-lactate levels. After IR, mucous membrane thickness and villi height decreased significantly, respectively by 30% and 45%, and electron-microscopic examination showed typical IR mucous membrane cell insult. IR also caused lactic acidosis (pH = 7.16 +/- 0.05 vs. 7.31 +/- 0.02, p < .01; L-lactate = 7.1 +/- 1.6 vs. 1.6 +/- 0.4 mmol/L, p = .001) and increased blood levels of transaminases. Concurrently, the inflammatory response was characterized by an increase in tumor necrosis factor-alpha (213 +/- 129 vs. 47 +/- 32 pg/mL, p < .05). However, blood levels of D-lactate never increased after IR.


CONCLUSIONS
D-lactate is not a reliable marker of gut IR in our model of supraceliac aortic clamping in rats.
Collange
Olivier
O
Département d'Anesthésie et de Réanimation, Hôpital Charles Nicolle, CHU de Rouen, France.
Tamion
Fabienne
F
Chanel
Stephane
S
Hue
Guy
G
Richard
Vincent
V
Thuilliez
Christian
C
Dureuil
Bertrand
B
Plissonnier
Didier
D
D000818:Animals; D001014:Aortic Aneurysm / Q000601:surgery*; D007249:Inflammation / Q000097:blood / Q000473:pathology; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008954:Models, Biological; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D013152:Splanchnic Circulation; D018709:Statistics, Nonparametric; D013237:Stereoisomerism
D019344:Lactic Acid