Peritoneal/Serum Lactate Ratio in Relaparotomy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 2
研究概览
简要总结
Laparotomy performed for both emergency of elective surgery may by complicated by intrabdominal collection, anastomotic leakage, infarction and others. This conditions are able to induce peritoneal inflammation. Inflamed peritoneum are able to produce excess of lactate that the investigators can measure by collecting fluid from peritoneal drainage.
Drainage were left in abdomen for monitoring intrabdominal condition until the passage of stool or flatus. Minimum drainage of serum is present daily also in uncomplicated post operative period.
Serum lactate relates with increased systemic anaerobic metabolism such as SIRS, sepsis and systemic hypoperfusion and it is easy to measure with a blood gas analysis.
The investigators hypothesized that the increases of peritoneal/ serum lactate ratio could be an earlier, sensible, non-invasive, and economical marker of post surgical complications. The decision whether and when to perform a relaparotomy in secondary peritonitis is largely subjective and based on professional experience. Actually no existing scoring system aids in this decision.
The aim of this study is to demonstrate that this ratio could be and useful tool for the surgeon in this decisional process.
详细描述
Post operative intraabdominal sepsis due to surgical complications is associated with an important mortality and morbidity. Early diagnosis is crucial to improve outcome. Relaparotomy could be necessary to eradicate the intraabdominal focus of sepsis or hypoperfusion. The relaparotomy must be performed early after the diagnosis of surgical complications before the onset of multi organ failure.
This prospective observational study includes the post operative period of consecutive patients requiring both major elective surgery and urgent laparotomy.
Demographic data, presence and nature of underlying disease and surgical diagnosis will be recorded on admission and study inclusion.
Daily after study inclusion, the investigators measure: venous blood gases, blood lactate and lactate presents in the fluid collected from the abdomen. Possum and SAPSII scores will be calculated daily or when a patient develops a rapid clinical deterioration.
The investigators follow patients with complicated or uncomplicated post operative period.
研究设计
- 研究类型
- Observational
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Post operative period of abdominal surgery (elective surgery of:colon-rectum, ileum, stomach and, pancreas)
- •Post operative period after Urgent laparotomy for both traumatic and/or non traumatic acute abdomen
- •Patients with signs of sepsis in the post operative period
- •Patients with signs of systemic hypoperfusion in the post operative
排除标准
- •Liver surgery
- •Drainage of bile, blood and dejection from abdominal drainage
- •Sepsis/ systemic hypoperfusion due to extraabdominal infection site