Changes in body fluid markers in intestinal ischemia

Liao, Xian-ping; She, Ya-xiong; Shi, Cheng-ren; Li, Min

doi:10.1016/0022-3468(95)90394-1

Cited by 52 publications

(45 citation statements)

References 12 publications

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“…This might reflect intestinal ischemia 21,22 or, more likely, systemic hypoperfusion 23,24 secondary to fluid loss into the GI tract coupled with inadequate fluid intake. As many patients with a high lactate concentration did not have intestinal ischemia severe enough for the attending surgeon to perform a resection, we believe it is more likely to reflect systemic hypoperfusion.…”

mentioning

confidence: 99%

Acid-Base and Electrolyte Abnormalities in Dogs with Gastrointestinal Foreign Bodies

Boag

Coe

Martinez

et al. 2005

Journal of Veterinary Internal Medicine

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Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra-or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75-0.95). Hyperlactatemia (Ͼ2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.Key words: Alkalosis; Hypochloremia; Hypokalemia; Hyponatremia; Linear. Dogs with clinical signs resulting from gastrointestinal foreign bodies are common in small-animal veterinary practice.1 Dogs ingest a large variety of objects that either pass through the gastrointestinal (GI) tract or cause a complete or partial obstruction. Other ingested objects act as linear foreign bodies and cause plication of the small intestine.2 Animals with GI disease frequently have acid-base and electrolyte abnormalities.3 Large volumes of fluid and electrolytes are secreted and reabsorbed by the healthy GI tract daily. In a 20-kg dog, approximately 2.5 L of fluid enters the GI tract from diet and normal gastrointestinal secretions and over 98% is reabsorbed daily. 4 Experimental studies of GI obstruction in dogs have revealed that, after an obstruction has been present for over 24 hours, there is secretion of sodium, potassium, and water rather than absorption in the bowel proximal to the obstruction. Gastrointestinal function is also abnormal distal to the obstruction. 5 Thus, disturbances in normal GI tract function secondary to complete or partial obstruction can rapidly result in disturbances of fluid balance, acid-base status, and serum electrolyte concentrations. Protracted or profuse vomiting and diarrhea with reluctance to consume adequate volumes of food and fluid can also affect the intravascular volume and hydration

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mentioning

confidence: 99%

Acid-Base and Electrolyte Abnormalities in Dogs with Gastrointestinal Foreign Bodies

Boag

Coe

Martinez

et al. 2005

Journal of Veterinary Internal Medicine

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“…De Laurier et al 9 reported that plasma lactate levels increased after 8 hours of experimental bowel strangulation in dogs, and several studies and experimental models have shown serum lactate levels to be useful in the accurate preoperative diagnosis of bowel strangulation. [9][10][11][12][13][14][15] In our studies, the time lag between strangulation and increase of lactate is 8 hours.…”

Section: Discussionmentioning

confidence: 99%

Lactate Levels in Bowel Strangulation With Experimental Animal Model

Tanaka

Hashimoto

Ohki

2015

International Surgery

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Bowel strangulation is a common disease and often requires an urgent operation. Our previous report showed that lactate concentration in the blood is a good predictive marker for emergency. However, the alteration in lactate levels during the course of bowel strangulation remains unclear. We have investigated the progressive increase of lactate after induction of bowel strangulation with animal experiments. Thirty-six mice were randomly divided into 6 groups: 0, 8, 16, 24, 48, and 72 hours after operation. Under anesthesia, laparotomy was performed and a 5-cm segment of terminal ileum with the mesenteric artery and veins was ligated to create a strangulation obstruction. After operation, the arterial blood was collected and lactate concentration and pH were measured using a blood gas analyzer. Lactate concentration in the 8-hour group was markedly increased, while pH decreased significantly (P , 0.05). Lactate concentrations were kept at a high level from 8 to 72 hours after operation. The time lag between strangulation and an increase of lactate is 8 hours. Our study is the first report of a bowel strangulation mouse model. Therefore, it would be possible to find a more specific marker of bowel strangulation using our experimental model.

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“…However, regardless of adequate oxygen delivery, the cells are unable to use oxygen during sepsis (76). During the initiation of intestinal ischemia, whatever the cause of injury (bowel strangulation, intestinal perforation or impaired blood flow), a rise in intracellular biomarkers occurs due to the increase of intestinal permeability (77). Therefore, metabolic levels are presented as useful measurements for the monitoring of intestinal ischemia.…”

Section: Gastrointestinal Perfusion Monitoringmentioning

confidence: 99%

“…A common approach is to place the microdialysis probe in the human peritoneal cavity (127)(128)(129). The assumption is that due to the high amount of intestinal anaerobic products metabolised by the liver, the metabolic markers of an impaired circulation are greater in the peritoneum than in blood (77). However, the ischemic biomarkers are diluted by non-ischemic markers and by the systemic circulation supplied to the peritoneum (78).…”

Section: Intestinal Microdialysismentioning

confidence: 99%