Serum lactate and acute mesenteric ischaemia: An observational, controlled multicentre study

Area of Science:

• Critical Care Medicine
• Gastroenterology
• Biomarker Research

Background:

• Acute mesenteric ischemia (AMI) presents with vague symptoms, complicating early diagnosis and management.
• Serum lactate (SL) is often considered a potential biomarker for AMI diagnosis and prognosis.
• Timely diagnosis and intervention are crucial for improving survival rates in AMI patients.

Purpose of the Study:

• To evaluate serum lactate (SL) as a diagnostic marker for acute mesenteric ischemia (AMI).
• To assess the prognostic value of SL in predicting outcomes for patients with AMI.

Main Methods:

• A multicenter case-control study involving intensive care unit (ICU) patients.
• Matching patients with AMI to a control group without AMI.
• Measuring and comparing SL levels on day 0 (D0) and day 1 (D1) post-ICU admission.
• Utilizing receiver operating characteristic (ROC) curves and area under the curve (AUC) to determine diagnostic and prognostic accuracy.

Main Results:

• No significant difference in SL levels was observed between AMI and control groups at D0 or D1.
• SL demonstrated poor diagnostic accuracy for AMI, with AUC values below 0.67 at both time points.
• SL levels at D0 and D1 were predictive of ICU mortality independently of AMI, with AUCs ranging from 0.69 to 0.76.

Conclusions:

• Serum lactate lacks specificity as a diagnostic marker for acute mesenteric ischemia (AMI).
• SL is not recommended for diagnosing AMI.
• Despite its lack of specificity for AMI, SL may contribute to assessing overall patient severity and predicting mortality in the ICU.