BACKGROUND: Intra-abdominal hypertension (IAH) often leads to abdominal compartment syndrome, which is followed by intestinal ischemia and associated with a high mortality. The diagnosis of abdominal compartment syndrome is difficult, and no valid biochemical markers are available. We conducted an experimental study on pigs to determine if D-lactate could be a useful biochemical marker of intestinal ischemia.
MATERIALS AND METHODS: A total of eight pigs (intervention group) underwent insufflation of carbon dioxide in the abdominal cavity to induce IAH and were compared with that of eight pigs (sham group) without IAH. Blood samples were taken from the portal and jugular veins at 0, 60, 120, 180, and 240 min after insufflation of carbon dioxide, and concentrations of D-lactate and L-lactate in the two groups were compared using an unpaired t-test.
RESULTS: The concentrations of D-lactate were increased in portal blood after 180 min of IAH (P = 0.036) and jugular blood after 240 min of IAH (P = 0.028) in the intervention group compared with those in the sham group. A similar tendency was found for L-lactate levels after 180 min of IAH (P = 0.032 and P = 0.017 for portal and jugular blood samples, respectively). Examination of the intestines revealed both macroscopic and microscopic signs of ischemia in all but one animal in the intervention group and only in one sham-pig.
CONCLUSIONS: Our findings suggest that D-lactate could be a useful biochemical marker of intestinal ischemia induced by IAH.