Intraperitoneal glycerol levels and lactate/pyruvate ratio: early markers of postoperative complications.

OBJECTIVE

We have previously presented microdialysis findings of early intraperitoneal (i.p.) metabolic disturbances, mainly an increased lactate/pyruvate (l/p) ratio, in surgical patients developing postoperative complications. The aim of the present study was to investigate i.p. glycerol and l/p ratio after major surgery with and without complications.

MATERIAL AND METHODS

Sixty patients were followed with microdialysis for 48 h after major abdominal surgery, 44 patients without postoperative complications and 16 patients with major surgical complications. Intraperitoneal and subcutaneous (s.c.) measurements of glycerol, lactate, pyruvate and glucose were performed, and the l/p ratio was calculated.

RESULTS

Intraperitoneal glycerol was significantly lower in the complication group compared with the control group (64 vs. 94.6 μM; p = 0.0015), while the i.p. l/p ratio was significantly higher in the complication group compared with the control group (13.7 vs. 11.1; p = 0.0073).

CONCLUSIONS

In this study, i.p. glycerol levels were lower and i.p. l/p ratio was higher in the immediate postoperative period in a group of patients with complications. These results might indicate early i.p. disturbances in fat and carbohydrate metabolism in patients who later developed symptoms of postoperative major complications.