Reviewer's report
Title:Luminal lactate in acute pancreatitis - Validation and relation to disease
severity.
Version: 1Date:30 November 2011
Reviewer: Hans-Ulrich Schulz
Reviewer's report:
In this research article, the authors tested the hypothesis that intestinal lactate
release occurs in acute pancreatitis and that a single measurement of rectal
luminal lactate at admission predicts the severity of acute pancreatitis including
length of hospital stay, need of intensive care and mortality.
Rectal luminal equilibration dialysis for the measurement of gut luminal lactate
was performed in 30 consecutive patients with acute pancreatitis. Three patients
had to be excluded from analysis because of technical failure (n=1) or missing
data (n=2). Of the remaining 27 patients, eight developed local complications.
One patients required admission to intensive care department. Mean hospital
stay was seven days. No mortality was observed.
High rectal luminal lactate was associated with low mucosal partial tension of
oxygen, indicating the physiological validity of the method. Rectal luminal lactate
at hospital admission was not associated with SOFA score, CRP level, length of
hospital or ICU stay, development of local complications or mortality. Low
precision and high bias was observed between two different lactate analyzers.
As adequately discussed by the authors themselves, the major limitation of the
investigation is the limited number of patients who suffered from severe acute
pancreatitis. Only one patient required intensive care and no deaths occurred.
Highest SOFA score was 3. For those reasons, the clinical value of a single
rectal luminal lactate measurement at admission to predict pancreatitis severity
remains obscure. In addition, two different methods of lactate analysis yielded
different results. However, since high rectal luminal lactate concentration was
associated with low mucosal partial tension of oxygen, the physiological validity
of the method could be established in acute pancreatitis for the first time by this
study.
The reviewer recommends major compulsory revisions to weaken the aims of the
investigation by the authors. Length of hospital stay, need for intensive care and
mortality aren’t appropriate study parameters in this small group of patients
suffering from mild acute pancreatitis in the majority of cases in whom no single
organ failure or death occurred.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Luminal lactate in acute pancreatitis - Validation and relation to disease
severity.
Version: 1Date:30 November 2011
Reviewer: Hans-Ulrich Schulz
Reviewer's report:
In this research article, the authors tested the hypothesis that intestinal lactate
release occurs in acute pancreatitis and that a single measurement of rectal
luminal lactate at admission predicts the severity of acute pancreatitis including
length of hospital stay, need of intensive care and mortality.
Rectal luminal equilibration dialysis for the measurement of gut luminal lactate
was performed in 30 consecutive patients with acute pancreatitis. Three patients
had to be excluded from analysis because of technical failure (n=1) or missing
data (n=2). Of the remaining 27 patients, eight developed local complications.
One patients required admission to intensive care department. Mean hospital
stay was seven days. No mortality was observed.
High rectal luminal lactate was associated with low mucosal partial tension of
oxygen, indicating the physiological validity of the method. Rectal luminal lactate
at hospital admission was not associated with SOFA score, CRP level, length of
hospital or ICU stay, development of local complications or mortality. Low
precision and high bias was observed between two different lactate analyzers.
As adequately discussed by the authors themselves, the major limitation of the
investigation is the limited number of patients who suffered from severe acute
pancreatitis. Only one patient required intensive care and no deaths occurred.
Highest SOFA score was 3. For those reasons, the clinical value of a single
rectal luminal lactate measurement at admission to predict pancreatitis severity
remains obscure. In addition, two different methods of lactate analysis yielded
different results. However, since high rectal luminal lactate concentration was
associated with low mucosal partial tension of oxygen, the physiological validity
of the method could be established in acute pancreatitis for the first time by this
study.
The reviewer recommends major compulsory revisions to weaken the aims of the
investigation by the authors. Length of hospital stay, need for intensive care and
mortality aren’t appropriate study parameters in this small group of patients
suffering from mild acute pancreatitis in the majority of cases in whom no single
organ failure or death occurred.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Luminal lactate in acute pancreatitis - Validation and relation to disease
severity.
Version: 1Date:30 November 2011
Reviewer: Hans-Ulrich Schulz
Reviewer's report:
In this research article, the authors tested the hypothesis that intestinal lactate
release occurs in acute pancreatitis and that a single measurement of rectal
luminal lactate at admission predicts the severity of acute pancreatitis including
length of hospital stay, need of intensive care and mortality.
Rectal luminal equilibration dialysis for the measurement of gut luminal lactate
was performed in 30 consecutive patients with acute pancreatitis. Three patients
had to be excluded from analysis because of technical failure (n=1) or missing
data (n=2). Of the remaining 27 patients, eight developed local complications.
One patients required admission to intensive care department. Mean hospital
stay was seven days. No mortality was observed.
High rectal luminal lactate was associated with low mucosal partial tension of
oxygen, indicating the physiological validity of the method. Rectal luminal lactate
at hospital admission was not associated with SOFA score, CRP level, length of
hospital or ICU stay, development of local complications or mortality. Low
precision and high bias was observed between two different lactate analyzers.
As adequately discussed by the authors themselves, the major limitation of the
investigation is the limited number of patients who suffered from severe acute
pancreatitis. Only one patient required intensive care and no deaths occurred.
Highest SOFA score was 3. For those reasons, the clinical value of a single
rectal luminal lactate measurement at admission to predict pancreatitis severity
remains obscure. In addition, two different methods of lactate analysis yielded
different results. However, since high rectal luminal lactate concentration was
associated with low mucosal partial tension of oxygen, the physiological validity
of the method could be established in acute pancreatitis for the first time by this
study.
The reviewer recommends major compulsory revisions to weaken the aims of the
investigation by the authors. Length of hospital stay, need for intensive care and
mortality aren’t appropriate study parameters in this small group of patients
suffering from mild acute pancreatitis in the majority of cases in whom no single
organ failure or death occurred.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
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