Normal values and differences between intraperitoneal and subcutaneous microdialysis in patients after non‐complicated gastrointestinal surgery

Jansson, Kjell; Jansson, Martin; Andersson, Magnus; Magnuson, Anders; Ungerstedt, U.; Norgren, Lars

doi:10.1080/00365510510013802

Cited by 35 publications

(31 citation statements)

References 16 publications

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“…TAP concentrations were below 0·1 µg/l in 31 of 33 patients with NSC. Glycerol levels were below 100 µmol/l in all patients in the OSC and NSC groups, and were similar to previously reported levels (38-221 µmol/l) in patients without complications after colorectal surgery 24 . TAP concentrations exceeding 0·1 µg/l (without high glycerol levels) were found in two patients who did not have POPF but who had leakage from either the hepaticojejunostomy or the gastrojejunostomy.…”

Section: Discussionsupporting

confidence: 90%

Early intraperitoneal metabolic changes and protease activation as indicators of pancreatic fistula after pancreaticoduodenectomy

Ansorge

Regnér

Segersvärd

et al. 2012

Journal of British Surgery

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Section: Discussionsupporting

confidence: 90%

Early intraperitoneal metabolic changes and protease activation as indicators of pancreatic fistula after pancreaticoduodenectomy

Ansorge

Regnér

Segersvärd

et al. 2012

Journal of British Surgery

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“…Normal intraperitoneal L/P ratio in patients after non-complicated gastrointestinal surgery is known to be under 15 [3] and still regarded as normal when under 20 whereas the ratio being over 20 depicts hypoxia in both splanchnic [4] and central nervous system [20]. Herein intraperitoneal L/P ratios were comparable.…”

Section: Discussionmentioning

confidence: 99%

“…Intestinal application of the method has been tested in several different experimental settings while clinical investigations are still scarce. Intramural [7,8], intraluminal [9-12] or intraperitoneal [1,3-6,9,11,13] location of microdialysis catheters has been suggested by different investigators.…”

Section: Introductionmentioning

confidence: 99%

Validation of Intraluminal and Intraperitoneal microdialysis in ischemic small intestine

et al. 2013

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BackgroundWe sought to define the sensitivity and specificity of intraperitoneal (IP) and intraluminal (IL) microdialysate metabolites in depicting ex vivo small intestinal total ischemia during GI-tract surgery. We hypothesized that IL as opposed to IP microdialysis detects small intestinal ischemia with higher sensitivity and specificity.MethodsIL and IP microdialysate lactate, pyruvate, glucose and glycerol were analysed from small intestine of pancreaticoduodenectomy patients before and after occluding the mesenteric vasculature and routine resection of a segment of small intestine. Ex vivo time sequences of microdialysate metabolites were described and ROC analyses after 0–30, 31–60, 61–90 and 91–120 minutes after the onset ischemia were calculated.ResultsIL lactate to pyruvate ratio (L/P ratio) indicated ischemia after 31–60 minutes with 0.954 ROC AUC (threshold: 109) in contrast to IP L/P (ROC AUC of 0.938 after 61–90 minutes, threshold: 18). At 31–60 minutes IL glycerol concentration indicated ischemia with 0.903 ROC AUCs (thresholds: 69 μmol/l). IP glycerol was only moderately indicative for ischemia after 91–120 minutes with 0,791 ROC AUCs (threshold 122 μmol/l). After 31–60 minutes IL and IP lactate to glucose ratios (L/G ratio) indicated ischemia with 0.956 and 0,942 ROC AUCs (thresholds: 48,9 and 0.95), respectively.ConclusionsThe results support the hypothesis that intraluminal application of microdialysis and metabolic parameters from the small intestinal lumen indicate onset of ischemia earlier than intraperioneal microdialysis with higher sensitivity and specificity.

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“…So far, the principle has been evaluated for intraperitoneal use. In animal studies and a few human studies, intraperitoneal microdialysis has been able to detect anastomotic bowel leakage before the development of signifi cant clinical symptoms [8][9][10][11][12][13][14][15]. The lactate/pyruvate ratio (L/P ratio) is the parameter with the highest sensitivity [15,16].…”

Section: Introductionmentioning

confidence: 99%

Mediastinal microdialysis: early diagnosis of anastomotic leakage after resection for esophageal cancer

et al. 2009

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The aim of the present study was to evaluate the safety of mediastinal microdialysis and its effi cacy regarding the early diagnosis of anastomotic leakage after gastroesophageal resection for esophageal cancer. Eight consecutive patients were included; one patient was excluded for reasons of catheter malfunction. The tip of the mediastinal microdialysis catheter was placed close to the anastomosis and held by a 4-0 absorbable suture. A subcutaneous microdialysis catheter placed in the pectoral region served as a reference. Samples collected every 4 h in the fi rst 8 postoperative days were analyzed for lactate, glucose, pyruvate, and glycerol and the lactate/pyruvate ratio (L/P ratio) was calculated. There were no procedure-related complications. Six patients had an uncomplicated postoperative course. In one patient, the L/P ratio was within normal range during the fi rst 20 h postoperatively, but a steady and signifi cant increase in L/P ratio then occurred, reaching a maximum of 105 after 124 h. The patient developed leakage symptoms on day 3, but endoscopy was unable to demonstrate any leakage. On the sixth postoperative day, blue dye administered through the nasogastric tube was recovered in the pleural drain. The leakage was treated with a covered selfexpanding metal stent; an immediate and signifi cant drop in the L/P ratio occurred. Mediastinal microdialysis seems to be a safe and promising tool in the early diagnosis of anastomotic leakage in patients undergoing gastroesophageal resection for cancer.

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Normal values and differences between intraperitoneal and subcutaneous microdialysis in patients after non‐complicated gastrointestinal surgery

Cited by 35 publications

References 16 publications

Early intraperitoneal metabolic changes and protease activation as indicators of pancreatic fistula after pancreaticoduodenectomy

Early intraperitoneal metabolic changes and protease activation as indicators of pancreatic fistula after pancreaticoduodenectomy

Validation of Intraluminal and Intraperitoneal microdialysis in ischemic small intestine

Mediastinal microdialysis: early diagnosis of anastomotic leakage after resection for esophageal cancer

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