title: Intraperitoneal glycerol levels and lactate/pyruvate ratio: early markers of postoperative complications.
abstract: OBJECTIVE
  We have previously presented microdialysis findings of early intraperitoneal (i.p.) metabolic disturbances, mainly an increased lactate/pyruvate (l/p) ratio, in surgical patients developing postoperative complications. The aim of the present study was to investigate i.p. glycerol and l/p ratio after major surgery with and without complications.
  
  
  METHODS
  Sixty patients were followed with microdialysis for 48 h after major abdominal surgery, 44 patients without postoperative complications and 16 patients with major surgical complications. Intraperitoneal and subcutaneous (s.c.) measurements of glycerol, lactate, pyruvate and glucose were performed, and the l/p ratio was calculated.
  
  
  RESULTS
  Intraperitoneal glycerol was significantly lower in the complication group compared with the control group (64 vs. 94.6 μM; p = 0.0015), while the i.p. l/p ratio was significantly higher in the complication group compared with the control group (13.7 vs. 11.1; p = 0.0073).
  
  
  CONCLUSIONS
  In this study, i.p. glycerol levels were lower and i.p. l/p ratio was higher in the immediate postoperative period in a group of patients with complications. These results might indicate early i.p. disturbances in fat and carbohydrate metabolism in patients who later developed symptoms of postoperative major complications.
authors: Department of Surgery, Örebro University Hospital, Örebro, Sweden. tal.horer@orebroll.se
authors: Tal M
authors: TM
authors: Hörer
authors: Lars
authors: L
authors: Norgren
authors: Kjell
authors: K
authors: Jansson
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D003082:Colectomy / Q000009:adverse effects; D005260:Female; D005990:Glycerol / Q000378:metabolism*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D019344:Lactic Acid / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity; D011183:Postoperative Complications / Q000175:diagnosis*; D019289:Pyruvic Acid / Q000378:metabolism*; D018709:Statistics, Nonparametric; D040521:Subcutaneous Tissue / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019344:Lactic Acid; D019289:Pyruvic Acid; D005990:Glycerol