Significance of Blood Lactate Level Determination in the Diagnosis of Acute Intestinal Obstruction in Elderly Patients

The aim of the investigation was to assess the significance of determining blood lactate level in the diagnosis of acute intestinal obstruction in elderly patients.

Materials and Methods. The data of blood lactate level determination in 82 elderly patients were studied. The first group included 39 elderly patients with acute intestinal obstruction, and the control group — 43 patients with various somatic pathologies. To determine the blood lactate level we used photocolorimetric method of lactate-oxidase reaction on a portable apparatus Accutrend^® Plus (Roche Diagnostics, Switzerland) using original test strips Accutrend^® Lactat (Roche Diagnostics, Switzerland).

Results. Acute intestinal obstruction was arrested conservatively in 12 patients of the first group, the lactate level being 3.32 [2.51; 3.96] mmol/L. 27 patients of group 1 were operated on. In 16 of them no critical intestinal ischemia requiring bowel resection was found. The mean values of this parameter in this category of patients before surgery were 5.14 [4.64; 5.63] mmol/L. Abdominoscopy showed 11 patients to have necrosis of the part of jejunum. Blood lactate level before surgery appeared to be 8.23 [7.36; 8.96] mmol/L. The blood lactate concentration in control patients was 1.89 [1.25; 2.30] mmol/L. In pair comparison of mean values of the indices under study in control patients and in different categories of patients the differences were significant (p<0.05).

Conclusion. When determining surgical indications in elderly patients with acute intestinal obstruction it is reasonable to consider the results of blood lactate test along with clinical and instrumental data. The higher the values of this parameter, the higher the possibility of intestinal necrosis to develop (r=0.46; p=0.037).

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Gavrilov S.V., Sabaury R.V., Menkov А.V. Significance of Blood Lactate Level Determination in the Diagnosis of Acute Intestinal Obstruction in Elderly Patients . Sovremennye tehnologii v medicine 2014; 6(4): 172