Lactate levels in bowel strangulation with experimental animal model.

Bowel strangulation is a common disease and often requires an urgent operation. Our previous report showed that lactate concentration in the blood is a good predictive marker for emergency. However, the alteration in lactate levels during the course of bowel strangulation remains unclear. We have investigated the progressive increase of lactate after induction of bowel strangulation with animal experiments. Thirty-six mice were randomly divided into 6 groups: 0, 8, 16, 24, 48, and 72 hours after operation. Under anesthesia, laparotomy was performed and a 5-cm segment of terminal ileum with the mesenteric artery and veins was ligated to create a strangulation obstruction. After operation, the arterial blood was collected and lactate concentration and pH were measured using a blood gas analyzer. Lactate concentration in the 8-hour group was markedly increased, while pH decreased significantly (P < 0.05). Lactate concentrations were kept at a high level from 8 to 72 hours after operation. The time lag between strangulation and an increase of lactate is 8 hours. Our study is the first report of a bowel strangulation mouse model. Therefore, it would be possible to find a more specific marker of bowel strangulation using our experimental model.

[1]  T. Iida,et al.  Lactate Levels in the Detection of Preoperative Bowel Strangulation , 2012, The American surgeon.

[2]  M. Schein,et al.  Small Bowel Obstruction—Who Needs an Operation? , 2010, World Journal of Surgery.

[3]  K. Matsushima,et al.  Effectiveness of Diagnostic Paracentesis and Ascites Analysis for Suspected Strangulation Obstruction , 2007, Journal of Gastrointestinal Surgery.

[4]  K. Azarow,et al.  Intestinal fatty acid binding protein (I-FABP) for the detection of strangulated mechanical small bowel obstruction. , 2006, Current surgery.

[5]  W. Henderson,et al.  Risk Factors for Adverse Outcomes Following Surgery for Small Bowel Obstruction , 2006, Annals of surgery.

[6]  Takayuki Yamamoto,et al.  The Value of Plasma Cytokine Measurement for the Detection of Strangulation in Patients With Bowel Obstruction: A Prospective, Pilot Study , 2005, Diseases of the colon and rectum.

[7]  K. Waxman,et al.  Intravenous Interleukin-6 Levels Predict Need for Laparotomy in Patients with Bowel Obstruction , 2001, The American surgeon.

[8]  J. Fischer,et al.  Lactate is an unreliable indicator of tissue hypoxia in injury or sepsis , 1999, The Lancet.

[9]  J. Vincent,et al.  Serial blood lactate levels can predict the development of multiple organ failure following septic shock. , 1996, American journal of surgery.

[10]  C. Shi,et al.  Changes in body fluid markers in intestinal ischemia. , 1995, Journal of pediatric surgery.

[11]  M. Murray,et al.  Serum D(-)-lactate levels as an aid to diagnosing acute intestinal ischemia. , 1994, American journal of surgery.

[12]  T. Scalea,et al.  Lactate clearance and survival following injury. , 1993, The Journal of trauma.

[13]  R. Cannon,et al.  Increased peritoneal fluid lactic acid values and progressive bowel strangulation in dogs. , 1989, American journal of surgery.

[14]  M. Sarr,et al.  Preoperative recognition of intestinal strangulation obstruction. Prospective evaluation of diagnostic capability. , 1983, American journal of surgery.

[15]  A. Shatila,et al.  Current status of diagnosis and management of strangulation obstruction of the small bowel. , 1976, American journal of surgery.