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Biochemical analysis of peritoneal fluid in patients with and without bacterial infection
H P Simmen1, H Battaglia, P Giovanoli
1Department of Surgery, University Hospital, Zürich, Switzerland.
Objective:
To find out if the concentrations of biochemical variables in peritoneal fluid differed in the presence or absence of infection.
Design:
Prospective study.
Setting:
University hospital, Switzerland.
Subjects:
80 patients undergoing abdominal operations, 23 of whom were operated on for an intra-abdominal infection. 57 Patients with no sign of infection served as controls.
Main Outcome Measures:
Concentrations of 24 biochemical variables measured in specimens of peritoneal fluid obtained during the operation.
Results:
Major differences between specimens taken from infected and uninfected patients including: glucose 5.4 compared with 0.8 mmol/l, lactate 7.9 and 17.2 mmol/l, aspartate aminotransferase 83 and 520 U/l, phosphate 1.1 and 3.7 mmol/l, potassium 4.5 and 10.1 mmol/l, lactate dehydrogenase 2021 and 7998 U/l, and gamma-glutamyl transferase 57 and 169 U/l.
Conclusion:
Intra-abdominal infection significantly alters the composition of peritoneal fluid. The assessment of milieu factors at the site of infection may help in the design of more predictive in vitro tests to guide antimicrobial treatment of intra-abdominal infections. In addition, the knowledge of discriminatory variables in peritoneal fluid may be useful in the diagnosis of intra-abdominal infection.