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Kinetics of d-lactate and ischemia-modified albumin after abdominal aortic surgery and their ability to predict intestinal ischemia

M. Tomandlova, T. Novotny, R. Staffa, J. Smutna, T. Krivka, P. Kruzliak, O. Slaby, L. Kubicek, R. Vlachovsky, L. Radova, J. Tomandl

. 2023 ; 112 (-) : 43-47. [pub] 20221208

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc23004353

OBJECTIVES: Acute intestinal ischemia is a severe complication of abdominal aortic surgery that is difficult to diagnose early and therefore to treat adequately and timely. In this study the perioperative kinetics of d-lactate and ischemia-modified albumin (IMA) are described and the predictive value of these markers for the early diagnosis of acute intestinal ischemia is assessed. DESIGN & METHODS: This non-randomised, single-centre cohort study enrolled 50 patients with abdominal aortic aneurysm (AAA) and 30 patients with aortoiliac occlusive disease (AOID). Serum d-lactate and IMA were assessed pre-, intra-, and postoperatively at eight defined time points. RESULTS: The highest serum d-lactate was at 6 h after complete declamping of the vascular graft. The highest predictive power of d-lactate was at 3 h after complete declamping (AUC 0.857). IMA was found to be higher in the AAA group in ischemic patients 10 min after complete declamping than in the AOID group. The highest predictive values of IMA were at 1 h after aortic cross-clamping (AUC 0.758) and 3 and 6 h after complete declamping (0.745 and 0.721, respectively). Moreover, the multivariate model with both markers at 3 h after complete declamping improved the detection of intestinal ischemia (AUC 0.894). CONCLUSIONS: Serum levels of IMA and d-lactate seem to be influential predictive markers for postoperative intestinal ischemia, especially after 3 h from complete declamping of vascular reconstruction.

Citace poskytuje Crossref.org

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$a Tomandlova, Marie $u Department of Biochemistry, Faculty of Medicine, Masaryk University, Kamenice 5, Brno 625 00, Czech Republic. Electronic address: mhyks@med.muni.cz
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$a Kinetics of d-lactate and ischemia-modified albumin after abdominal aortic surgery and their ability to predict intestinal ischemia / $c M. Tomandlova, T. Novotny, R. Staffa, J. Smutna, T. Krivka, P. Kruzliak, O. Slaby, L. Kubicek, R. Vlachovsky, L. Radova, J. Tomandl
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$a OBJECTIVES: Acute intestinal ischemia is a severe complication of abdominal aortic surgery that is difficult to diagnose early and therefore to treat adequately and timely. In this study the perioperative kinetics of d-lactate and ischemia-modified albumin (IMA) are described and the predictive value of these markers for the early diagnosis of acute intestinal ischemia is assessed. DESIGN & METHODS: This non-randomised, single-centre cohort study enrolled 50 patients with abdominal aortic aneurysm (AAA) and 30 patients with aortoiliac occlusive disease (AOID). Serum d-lactate and IMA were assessed pre-, intra-, and postoperatively at eight defined time points. RESULTS: The highest serum d-lactate was at 6 h after complete declamping of the vascular graft. The highest predictive power of d-lactate was at 3 h after complete declamping (AUC 0.857). IMA was found to be higher in the AAA group in ischemic patients 10 min after complete declamping than in the AOID group. The highest predictive values of IMA were at 1 h after aortic cross-clamping (AUC 0.758) and 3 and 6 h after complete declamping (0.745 and 0.721, respectively). Moreover, the multivariate model with both markers at 3 h after complete declamping improved the detection of intestinal ischemia (AUC 0.894). CONCLUSIONS: Serum levels of IMA and d-lactate seem to be influential predictive markers for postoperative intestinal ischemia, especially after 3 h from complete declamping of vascular reconstruction.
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$a Novotný, Tomáš $u 2(nd) Department of Surgery, Center for Vascular Disease, St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic; 2(nd) Department of Surgery, Center for Vascular Disease, Faculty of Medicine, Masaryk University, Pekarska 53, Brno 656 91, Czech Republic. Electronic address: tomas.novotny@fnusa.cz $7 xx0079419
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$a Staffa, Robert $u 2(nd) Department of Surgery, Center for Vascular Disease, St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic; 2(nd) Department of Surgery, Center for Vascular Disease, Faculty of Medicine, Masaryk University, Pekarska 53, Brno 656 91, Czech Republic. Electronic address: robert.staffa@fnusa.cz
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$a Smutna, Jindra $u Department of Biochemistry, Faculty of Medicine, Masaryk University, Kamenice 5, Brno 625 00, Czech Republic. Electronic address: smutna@med.muni.cz
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$a Krivka, Tomas $u Department of Medical Imaging, St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic; Department of Medical Imaging, Faculty of Medicine, Masaryk University, Pekarska 53, Brno 656 91, Czech Republic. Electronic address: tomas.krivka@fnusa.cz
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$a Kruzliak, Peter $u 2(nd) Department of Surgery, Center for Vascular Disease, St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic; 2(nd) Department of Surgery, Center for Vascular Disease, Faculty of Medicine, Masaryk University, Pekarska 53, Brno 656 91, Czech Republic
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$a Slaby, Ondrej $u Central European Institute of Technology, Masaryk University, Kamenice 5, Brno 625 00, Czech Republic; Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5, Brno 625 00, Czech Republic. Electronic address: oslaby@med.muni.cz
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$a Kubicek, Lubos $u 2(nd) Department of Surgery, Center for Vascular Disease, St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic; 2(nd) Department of Surgery, Center for Vascular Disease, Faculty of Medicine, Masaryk University, Pekarska 53, Brno 656 91, Czech Republic. Electronic address: lubos.kubicek@fnusa.cz
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$a Vlachovsky, Robert $u 2(nd) Department of Surgery, Center for Vascular Disease, St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic; 2(nd) Department of Surgery, Center for Vascular Disease, Faculty of Medicine, Masaryk University, Pekarska 53, Brno 656 91, Czech Republic. Electronic address: robert.vlachovsky@fnusa.cz
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$a Radova, Lenka $u Central European Institute of Technology, Masaryk University, Kamenice 5, Brno 625 00, Czech Republic. Electronic address: 232848@mail.muni.cz
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$a Tomandl, Josef $u Department of Biochemistry, Faculty of Medicine, Masaryk University, Kamenice 5, Brno 625 00, Czech Republic. Electronic address: tomandl@med.muni.cz
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