title: L- and D-lactate as biomarkers of arterial-induced intestinal ischemia: an experimental study in pigs.
abstract: BACKGROUND
  Intestinal ischemia is difficult to diagnose, and search for new biomarkers has led to interest in D-lactate, which arises from bacterial fermentation in the gastrointestinal tract.
  
  
  METHODS
  The superior mesenteric artery was clamped in eight pigs for 6 h to induce ischemia of the intestine. Eight sham-operated pigs served as controls. Systemic and portal plasma D- and L-lactate were sampled in 1 h intervals. L-LDH was inactivated prior to D-lactate measurement by addition of NaOH.
  
  
  RESULTS
  In systemic vein samples, we found a significant mean difference in the change of D-lactate from baseline to 6 h between the sham and intervention group (.007 ± .011 mmol/l vs. .030 ± .013 mmol/l, respectively) (P = .020). Both systemic and portal circulation levels of plasma L-lactate increased significantly between the two groups within an hour. The mean difference for L-lactate were -.020 ± .215 mmol/l and 1.440 ± 1.454 mmol/l in the sham and intervention group, respectively (P = .009).
  
  
  CONCLUSIONS
  L-lactate was found to be a marker of arterial-induced intestinal ischemia in both the systemic and portal circulation. There was no significant elevation of D-lactate at either site during the 6 h of ischemia.
authors.affiliation: Vascular Research Unit, Department of Vascular Surgery, Viborg Regional Hospital, Denmark. casper.dr@gmail.com
authors.forename: Casper
authors.initials: C
authors.lastname: Nielsen
authors.forename: Frank V
authors.initials: FV
authors.lastname: Mortensen
authors.forename: Erland J
authors.initials: EJ
authors.lastname: Erlandsen
authors.forename: Jes S
authors.initials: JS
authors.lastname: Lindholt
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood / Q000737:chemistry; D005260:Female; D007422:Intestines / Q000098:blood supply* / Q000473:pathology; D007511:Ischemia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D019344:Lactic Acid / Q000097:blood* / Q000737:chemistry; D017538:Mesenteric Artery, Superior; D013552:Swine
chemical_list: D015415:Biomarkers; D019344:Lactic Acid; D007770:L-Lactate Dehydrogenase