Intraperitoneal microdialysis in the postoperative surveillance after surgery for necrotizing enterocolitis: a preliminary report

Pedersen, Mark Ellebæk; Dahl, Marianne; Qvist, Niels

doi:10.1016/j.jpedsurg.2010.11.015

Cited by 22 publications

(15 citation statements)

References 6 publications

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“…Microdialysis has also being used clinically to detect ischemia, most often to monitor patients after brain injury [68], but also for monitoring liver transplants [69] and viability of muscle flaps after reconstructive surgery [70] and for evaluating coronary perfusion after coronary artery bypass surgery [38]. Furthermore, peritoneal microdialysis of lactate has also been applied in gastrointestinal surgery to monitor anastomotic leaks and infections [71,72]. Insertion of the microdialysis catheters into the myocardium of the left ventricle was performed similarly to the PtCO 2 sensors.…”

Section: Microdialysismentioning

confidence: 99%

Continuous Monitoring of Regional Function by a Miniaturized Ultrasound Transducer Allows Early Quantification of Low-Grade Myocardial Ischemia

Hyler

Pischke

Halvorsen

et al. 2015

Journal of the American Society of Echocardiography

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The epicardially attached miniaturized ultrasound transducer allowed the precise detection of different levels of coronary flow reduction. The results also showed a quantitative and linear relationship among coronary flow, ischemia, and myocardial function. Thus, the ultrasound transducer has the potential to improve the monitoring of myocardial ischemia and to detect graft failure during and after heart surgery.

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Section: Microdialysismentioning

confidence: 99%

Continuous Monitoring of Regional Function by a Miniaturized Ultrasound Transducer Allows Early Quantification of Low-Grade Myocardial Ischemia

Hyler

Pischke

Halvorsen

et al. 2015

Journal of the American Society of Echocardiography

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“…In the United States, its clinical application is presently restricted to neurointensive care units because only the brain catheter (CMA 70, M Dialysis AB, Stockholm, Sweden) is approved by the Food and Drug Administration for clinical use. In Europe, it is also Conformité Européenne–marked for reconstructive surgery with muscle or subcutaneous flaps,20 gastrointestinal surgery for the detection of anastomotic leaks or infections,21, 22 liver surgery,23 and surgery in other organs. A membrane with a pore size of 20 kDa can detect metabolic substances (lactate, pyruvate, glucose, and glycerol), whereas a pore size of 100 kDa allows measurements of mediators of inflammation (cytokines, chemokines, and complement) without an increase in the outer diameter of the catheter.…”

mentioning

confidence: 99%

Early bedside detection of ischemia and rejection in liver transplants by microdialysis

et al. 2012

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This study was performed to explore whether lactate, pyruvate, glucose, and glycerol levels sampled via microdialysis catheters in the transplanted liver could be used to detect ischemia and/or rejection. The metabolites were measured at the bedside every 1 to 2 hours after the operation for a median of 10 days. Twelve grafts with biopsy-proven rejection and 9 grafts with ischemia were compared to a reference group of 39 grafts with uneventful courses. The median lactate level was significantly higher in both the ischemia group [5.8 mM (interquartile range ¼ 4.0-11.1 mM)] and the rejection group [2.1 mM (interquartile range ¼ 1.9-2.4 mM)] versus the reference group [1.5 mM (interquartile range ¼ 1.1-1.9 mM), P < 0.001 for both]. The median pyruvate level was significantly increased only in the rejection group [185 lM (interquartile range ¼ 155-206 lM)] versus the reference group [124 lM (interquartile range ¼ 102-150 lM), P < 0.001], whereas the median lactate/ pyruvate ratio and the median glycerol level were increased only in the ischemia group [66.1 (interquartile range ¼ 23.9-156.7) and 138 lM (interquartile range ¼ 26-260 lM)] versus the reference group [11.8 (interquartile range ¼ 10.6-13.6), P < 0.001, and 9 lM (interquartile range ¼ 9-24 lM), P ¼ 0.002]. Ischemia was detected with 100% sensitivity and greater than 90% specificity when a positive test was repeated after 1 hour. In 3 cases of hepatic artery thrombosis, ischemia was detected despite normal blood lactate levels. Consecutive pathological measurements for 6 hours were used to diagnose rejection with greater than 80% sensitivity and specificity at a median of 4 days before the activity of alanine aminotransferase, the concentration of bilirubin in serum, or both increased. In conclusion, bedside measurements of intrahepatic lactate and pyruvate levels were used to detect ischemia and rejection earlier than current standard methods could. Discrimination from an uneventful patient course was achieved. Consequently, intrahepatic graft monitoring with microdialysis may lead to the earlier initiation of graft-saving treatment. Liver Transpl 18: 839-849, 2012. V C 2012 AASLD. Received December 9, 2011 accepted February 29, 2012.As many as 20% of transplanted liver grafts are lost within the first year despite considerable therapeutic improvements in treatment during the last decades.1 Most grafts are lost within the first week or weeks. As a result, attempts to improve overall graft survival rates should include the early detection and adequate treatment of complications such as acute rejection 2 and vascular occlusion with subsequent ischemia.3 The latter is an especially major contributor to the loss of grafts. Biliary complications and infections are other organ-threatening complications. [4][5][6]

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“…Traditionally, glycerol, lactate, pyruvate and glucose are the substances that most frequently have been measured using the microdialysis principle [10, 13, 15–23] as commercially available equipment provides bedside measurements of these substances. Under anaerobic conditions (e.g.…”

Section: Methodsmentioning

confidence: 99%

Intraperitoneal lactate/pyruvate ratio and the level of glucose and glycerol concentration differ between patients surgically treated for upper and lower perforations of the gastrointestinal tract: a pilot study

et al. 2017

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BackgroundSecondary peritonitis is a condition associated with high morbidity and mortality. Continuous postoperative monitoring of patients to ensure timely intervention to treat complications without delay is important for survival and outcome. We aimed to (1) investigate potential differences in postoperative intraperitoneal biomarker levels between patients with upper and lower gastrointestinal tract lesion, and (2) compare postoperative biomarker levels between complicated and uncomplicated patients.MethodsWe included a total of 15 consecutive patients operated for upper (n = 7) and lower (n = 8) gastrointestinal tract perforation. We registered postoperative complications during a 30 days follow up-period. Complications were defined as intraabdominal complications, septic shock, and mortality. 5 patients were complicated. A microdialysis catheter was placed intraperitoneally in each patient. Samples were collected every 4th hour for up to 7 postoperative days. Samples were analysed for concentrations of glucose, lactate, pyruvate and glycerol.ResultsMicrodialysis results showed that patients with upper gastrointestinal tract lesions had significantly higher levels of postoperative intraperitoneal glucose and glycerol concentrations, as well as lower lactate/pyruvate ratios and lactate/glucose ratios. In the group with perforation of the lower gastrointestinal tract, those patients with a complicated course showed lower levels of postoperative intraperitoneal glucose concentration and glycerol concentration and higher lactate/pyruvate ratios and lactate/glucose ratios than those patients with an uncomplicated course.ConclusionPatients with upper and lower gastrointestinal tract lesions showed differences in postoperative biomarker levels. A difference was also seen between patients with complicated and uncomplicated postoperative courses.

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Intraperitoneal microdialysis in the postoperative surveillance after surgery for necrotizing enterocolitis: a preliminary report

Cited by 22 publications

References 6 publications

Continuous Monitoring of Regional Function by a Miniaturized Ultrasound Transducer Allows Early Quantification of Low-Grade Myocardial Ischemia

Continuous Monitoring of Regional Function by a Miniaturized Ultrasound Transducer Allows Early Quantification of Low-Grade Myocardial Ischemia

Early bedside detection of ischemia and rejection in liver transplants by microdialysis

Intraperitoneal lactate/pyruvate ratio and the level of glucose and glycerol concentration differ between patients surgically treated for upper and lower perforations of the gastrointestinal tract: a pilot study

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