D-Lactate is not a reliable marker of gut ischemia-reperfusion in a rat model of supraceliac aortic clamping

Objective: D-Lactate is the dextrorotatory form Of L-lactate. L-Lactate is the isomer routinely tested in clinical practice to assess cell hypoxemia. D-Lactate has been recently proposed as a specific marker of gut ischemia-reperfusion (IR), particularly after surgery for ruptured aortic aneurysms. We sought to assess D-lactate as a reliable marker of gut IR in a rat model of supraceliac aortic clamping. Design: Prospective, randomized trial. Setting. Animal research center. Subjects: Male Wistar rats. Interventions: After general anesthesia, rats were randomized into two groups (n = 8 in each). The IR group underwent a laparotomy, aortic clamping for 40 mins, and 1 hr of reperfusion. The control group underwent the same procedure, except for aortic clamping. Measurements and Main Results: The following variables were tested after 1 hr of reperfusion (IR group) or after the equivalent time (control group): 1) tissue and cell insult via ileum morphometry and electron microscopy, serum glutamic transaminases (serum glutamic-oxaloacetic transaminase and serum glutamic-pyruvic transaminase), pH, and L-lactate; 2) systemic inflammatory response via tumor necrosis factor-alpha; and 3) D-lactate levels. After IR, mucous membrane thickness and villi height decreased significantly, respectively by 30% and 45%, and electron-microscopic examination showed typical IR mucous membrane cell insult. IR also caused lactic acidosis (pH = 7.16 +/- 0.05 vs. 7.31 +/- 0.02, p <.01; L-lactate = 7.1 +/- 1.6 vs. 1.6 +/- 0.4 mmol/L, p =.001) and increased blood levels of transaminases. Concurrently, the inflammatory response was characterized by an increase in tumor necrosis factor-alpha (213 +/- 129 vs. 47 +/- 32 pg/mL, p <.05). However, blood levels Of D-lactate never increased after IR. Conclusions: D-Lactate is not a reliable marker of gut IR in our model of supraceliac aortic clamping in rats.