Intraperitoneal microdialysis: Postoperative monitoring of splanchnic ischemia by measurements of the lactate pyruvate ratio*

Jansson, Martin; Strand, Ida E U Hall; Jansson, Kjell

doi:10.1097/01.ccm.0000239419.32573.34

Cited by 10 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In eight of the included studies, there was a discrepancy between outcomes listed in the method section and the result section and/or an unclear definition of outcomes in the study [13,15,20,25,27,[30][31][32].…”

Section: Risk Of Bias Across Studiesmentioning

confidence: 99%

“…Several studies have investigated the applicability of microdialysis in postoperative monitoring of patients undergoing colorectal resection [20][21][22][23][24][25]. In a study by Jansson et al [21], the safety of peritoneal microdialysis in eight patients who had undergone right-sided hemicolectomy with primary anastomosis for colonic neoplasia was investigated.…”

Section: Bowel Surgerymentioning

confidence: 99%

“…The median L/P ratio varied according to catheter location, with the highest values being recorded adjacent to the anastomosis, and it was concluded that catheters should be near the anastomosis. Four patients had repeatedly high L/P ratios (defined as a ratio [20) measured adjacent to the anastomosis and/or within the small intestinal loops. Two patients experienced postoperative anastomotic leakage (AL).…”

Section: Bowel Surgerymentioning

confidence: 99%

See 2 more Smart Citations

Microdialysis in Postoperative Monitoring of Gastrointestinal Organ Viability: A Systematic Review

2018

View full text Add to dashboard Cite

Background Microdialysis is a technique for continuous measurement of extracellular substances. It may be used to monitor tissue viability. The clinical implications of using microdialysis as a tool in gastrointestinal surgery have yet to be defined. The aim of the present study was to evaluate the clinical significance of microdialysis with special attention to different markers measured to predict the clinical outcome of surgical patients. Methods Embase, MEDLINE, and the Cochrane Library were searched systematically for human studies written in English. Study selection, data extraction, and quality assessment were performed independently by two authors. We included studies in which the microdialysis technique was used for postoperative monitoring of patients undergoing gastrointestinal surgery. To be eligible, studies had to compare patients with and without postoperative complications. Results Twenty‐six studies were included in this review. MINORS score ranged from 3 to 12 (median 10.5). Most studies showed that levels of biomarkers obtained by microdialysis correlated with the postoperative clinical course. Lactate, pyruvate, glucose, and glycerol were the most frequently measured biomarkers. Several studies found that changes in biomarkers in complicated patients preceded symptoms of complications and/or changes in conventional paraclinical methods of postoperative monitoring. Conclusions Studies show that microdialysis may have the potential to become a tool in postoperative surveillance of surgical patients. Larger randomized studies are needed to define the clinical implications of microdialysis.

show abstract

Section: Risk Of Bias Across Studiesmentioning

confidence: 99%

Section: Bowel Surgerymentioning

confidence: 99%

Section: Bowel Surgerymentioning

confidence: 99%

See 1 more Smart Citation

Microdialysis in Postoperative Monitoring of Gastrointestinal Organ Viability: A Systematic Review

2018

View full text Add to dashboard Cite

show abstract

“…27,42 This finding emphasises that the ip l/p ratio is unspecific and might reflect any organ hypoperfusion or inflammatory process. 43 This series has a higher percentage of severe IAH than reported in the literature. This might be explained by our institution's policy of 'rEVAR whenever possible' 29 and an active attitude during the study period to follow the development of IAH hourly in the ICU.…”

Section: Discussionmentioning

confidence: 61%

Intra-peritoneal Microdialysis and Intra-abdominal Pressure after Endovascular Repair of Ruptured Aortic Aneurysms

Hörer

Skoog

Norgren

et al. 2013

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

show abstract

“…In gastrointestinal surgery, the importance of the intraperitoneal cavity with increasing lactate and lactate / pyruvate ratio has been demonstrated, as evidence of hypoxia / ischemia early in the course of patients who later develop anastomotic leakage3 [14][15][16][17]. Measurements of intraperitoneal glycerol have been performed in studies of this patient group and have shown decreasing levels in patients who later develop anastomosis leakage and a possible explanation for this was an increased consumption [18,19].…”

Section: Discussionmentioning

confidence: 96%

Postoperative Lipolysis, Intraperitoneal and Subcutaneously during Epidural Analgesia

Jansson

2019

AJGH

View full text Add to dashboard Cite

Objective: The introduction of epidural anesthesia in the first postoperative days has shown in previous studies not only better pain relief but also lower postoperative metabolism and inflammation in these patients. It has certainly not been possible to establish the mechanisms behind this.Methods: 14 patients with epidural anesthesia were compared with 6 patients without epidural anesthesia after major gastrointestinal surgery. Metabolic microdialysis measurements were used subcutaneously and intraperitoneally for comparison. The assays were glucose, pyruvate, lactate and glycerol. Results:The results showed significantly lower glycerol levels in patients with post-operative pain relief with epidural catheters both intraperitoneally and subcutaneously. No differences could be detected in analyzes of glucose, pyruvate and lactate, but differences in glycerol could be detected. Intraperitoneally with epidural catheter median glycerol value was 97.5 vs 152 µmol / L for patients without epidural catheter. Subcutaneous median was 245 µmol / L in patients with epidural catheter vs 336 in patients without. Higher glycerol values were observed subcutaneously compared to intraperitoneal. Conclusion:Probably the higher glycerol levels seen subcutaneously are due to greater fat content in subcutaneous tissue. We interpret the lower glycerol levels seen in postoperative pain relief in patients with epidural catheters, both subcutaneously and intraperitoneally as a sign that the hormone-induced initiation of lipolysis is controlled by neurogenic mechanisms of the autonomic nervous system.

show abstract

Intraperitoneal microdialysis: Postoperative monitoring of splanchnic ischemia by measurements of the lactate pyruvate ratio*

Cited by 10 publications

References 12 publications

Microdialysis in Postoperative Monitoring of Gastrointestinal Organ Viability: A Systematic Review

Microdialysis in Postoperative Monitoring of Gastrointestinal Organ Viability: A Systematic Review

Intra-peritoneal Microdialysis and Intra-abdominal Pressure after Endovascular Repair of Ruptured Aortic Aneurysms

Postoperative Lipolysis, Intraperitoneal and Subcutaneously during Epidural Analgesia

Contact Info

Product

Resources

About