[Interest of D-lactate as a colic hypoperfusion marker during aortic abdominal aneurysm surgery].
OBJECTIVE
D-lactate is the dextrogyre form of the lactate usually measured in intensive care. Its bacterial origin should make it a marker of translocation during gut ischemia. The aim was to test D-lactate as a postoperative marker of colic hypoperfusion measured during aortic surgery.


METHODS
Prospective observational cohort study.


METHODS
Patients operated for abdominal aortic aneurysm. Two groups were stratified on inferior mesenteric arterial residual pressure (IMArP) measured during the surgery: Colic hypoperfusion during surgery (CHs) group: patients with an IMArP < 40 mmHg.


METHODS
patients with an IMArP > or = 40 mmHg. Baseline data such as age, duration of aortic clamping and severity score (IGS II) were collected. The D-lactate was measured in postoperative at admission time in ICU and then daily. D-lactate(max) defined the maximum value of D-lactate for one patient.


RESULTS
Twenty-nine patients were included, 23 in the control group and 6 in the CHs group. Groups were comparable at baseline. D-lactate(max) was significantly higher in the CHs group (median: 0.13 mmol/l; min-max: 0.03-0.9 mmol/l) than in the control group (0.03; 0-0.26 mmol/l, p=0.007).


CONCLUSIONS
D-lactate could be postoperative marker of colic hypoperfusion measured during surgery for abdominal aortic aneurysm.
Collange
O
O
Département d'anesthésie-réanimation, hôpital Charles-Nicolle, CHU de Rouen, 76031 Rouen, France. olivier.collange@chru-strasbourg.fr
Veber
B
B
Tamion
F
F
Lavoine
A
A
Plissonnier
D
D
Dureuil
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003422:Critical Care; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011184:Postoperative Period; D015203:Reproducibility of Results
D015415:Biomarkers; D019344:Lactic Acid