Hyperlactat�mie bei Darmisch�mie

Nutz, V.; Sommer, H

doi:10.1007/bf01254084

Cited by 3 publications

(3 citation statements)

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“…This seemingly specific increase in serum lactate in acute mesenteric ischemia was also advocated by Nutz and Sommer [19], who noted that the rationale for measuring serum lactate is the high demand of the intestine for blood and oxygen and thus its high ischemic vulnerability. They postulated that in the presence of ischemia, intestinal cells would depend on anaerobic metabolism, resulting in acidosis and a serum lactic acid increase (lactacidemia) even before necrosis of the tissue [19]. While this idea was repeatedly supported by additional clinical studies [20,21], these studies did not include specific remarks on the potential time delay between the onset of ischemia and time of diagnosis.…”

Section: Emergence Of Serum Lactate Measurement In Diagnosing Acute Mmentioning

confidence: 98%

“…Furthermore, among patients with acute abdomen and intestinal vascular occlusion, there was a 7-fold increase in serum lactate as opposed to patients without intestinal ischemia [18]. This seemingly specific increase in serum lactate in acute mesenteric ischemia was also advocated by Nutz and Sommer [19], who noted that the rationale for measuring serum lactate is the high demand of the intestine for blood and oxygen and thus its high ischemic vulnerability. They postulated that in the presence of ischemia, intestinal cells would depend on anaerobic metabolism, resulting in acidosis and a serum lactic acid increase (lactacidemia) even before necrosis of the tissue [19].…”

Section: Emergence Of Serum Lactate Measurement In Diagnosing Acute Mmentioning

confidence: 99%

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Beyond Lactate: Is There a Role for Serum Lactate Measurement in Diagnosing Acute Mesenteric Ischemia?

Demir

Ceyhan²,

Friess³

2012

Dig Surg

121

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Background/Aims: Measurement of serum lactate remains the most frequently applied laboratory investigation to diagnose acute mesenteric (intestinal) ischemia. The present review aims at critically questioning the widespread measurement of serum lactate to diagnose acute mesenteric ischemia in clinical practice and at drawing attention to more novel markers of intestinal ischemia. Methods: An electronic search of multiple databases was performed with the key words ‘lactate’, ‘marker’, ‘mesenteric’, ‘intestinal’ and ‘ischemia’ to detect all relevant studies. Additionally, the references of published articles were also reviewed. Results: Serum lactate is an unspecific marker of tissue hypoperfusion and undergoes significant elevation only after advanced mesenteric damage. While L-lactate is the routinely measured stereoisomer of lactate, the other stereoisomer, D-lactate, has been shown to bear a somewhat higher specificity, which is still not comparable to the extremely specific nature of ischemia markers from other organs (e.g. cardiac ischemia). Larger studies are currently lacking to reliably advocate the routine clinical usage of novel markers like mucosal damage markers such as intestinal fatty acid-binding protein. Conclusion: Based on current evidence, the level of no single serum marker, including serum lactate, is elevated early and specifically enough in the serum to diagnose acute mesenteric ischemia.

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Section: Emergence Of Serum Lactate Measurement In Diagnosing Acute Mmentioning

confidence: 98%

Section: Emergence Of Serum Lactate Measurement In Diagnosing Acute Mmentioning

confidence: 99%

Beyond Lactate: Is There a Role for Serum Lactate Measurement in Diagnosing Acute Mesenteric Ischemia?

Demir

Ceyhan²,

Friess³

2012

Dig Surg

121

View full text Add to dashboard Cite

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“…Several clinical studies reported increased L-lactate blood values in the vast majority of patients with acute mesenteric ischemia (12,15). More specifically, Janda et al (16) showed a 10-fold increase of lactic acid in patients who developed postoperative occlusion of intestinal arteries.…”

Section: Biomarkers Of Hypoxia and Oxidative Stressmentioning

confidence: 99%

Biochemical markers of acute intestinal ischemia: possibilities and limitations

2018

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Acute intestinal ischemia is a relative rare abdominal emergency, associated with considerably high morbidity and mortality rates. Although the conventional diagnostic approach to acute intestinal ischemia entails a preliminary evaluation of signs and symptoms, followed by radiological and laboratory investigations, a definitive diagnosis is can usually be made after laparotomy, which still remains the gold standard diagnostic (and therapeutic) procedure. Several potential laboratory biomarkers have been investigated over the past decades, but none of these seems to reach a suitable diagnostic accuracy for an early and reliable diagnosis of intestinal ischemia. The aim of this narrative review is to provide an overview on traditional laboratory tests for diagnosing acute intestinal ischemia (i.e., complete blood count, D-dimer, blood gas analysis, total lactic acid, C-reactive protein and procalcitonin), and summarize current evidence regarding some emerging and potentially useful biomarkers such as D-lactate, intestinal fatty acid-binding protein (I-FABP), ischemia modified albumin (IMA), α-glutathione S-transferase (α-GST), interleukin-6 (IL-6), citrulline and smooth muscle protein of 22 kDa (SM22). Among the various tests, D-lactate, IMA and I-FABP are perhaps the most promising, since they are characterized by optimal sensitivity and relatively good specificity, early kinetics, and can be measured with assays suited for a rapid diagnosis.

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