The supply of
oxygen is limited in certain intra abdominal conditions due to direct vascular invasion or inflammatory process, resulting in high
lactate levels. Aim of this study was to find the predictive value of
lactate levels in the peritoneal fluid (PF) and blood of patients with
acute abdomen. The study comprised of fifty patients with acute abdominal conditions, admitted in emergency ward of tertiary care hospital, thirty patients were with surgical abdomen (group I) and twenty patients with non surgical abdomen (group II).
Lactate was estimated in PF and blood on Blood Gas Analyzer (NOVA, M-7). The mean
lactate levels in PF were significantly higher in group I as compared to group II (14.65 ± 1.195 vs. 5.92 ± 0.97 mmol/L, p < 0.001). There was no significant difference in blood
lactate levels in both the groups. When PF and blood
lactate levels were compared within groups, we found that PF levels were significantly higher than blood in group I (14.65 ± 1.195 vs. 3.85 ± 0.54 mmol/L, p < 0.001) but not in group II (5.92 ± 0.97 vs. 4.36 ± 0.95 mmol/L). Diagnostic value was obtained using ROC curve. Cut off values obtained for PF
lactate, difference and ratio of PF and blood
lactate (≥6.4 mmol/L, ≥3.3 and ≥2.1 respectively) are at very high degree of sensitivity and specificity. So it can be useful marker of surgical emergency in patients with acute intra abdominal pathology, especially in clinically ill patients or in whom physical examination is not yielding because of
neurologic disorders or unresponsiveness.