BIOCHEMICAL-ANALYSIS OF PERITONEAL-FLUID IN PATIENTS WITH AND WITHOUTBACTERIAL-INFECTION

Objective: To find out if the concentrations of biochemical variables in peritoneal fluid differed in the presence or absence of infection. Design: Prospective study. Setting: University hospital, Switzerland. Subjects: 80 patients undergoing abdominal operations, 23 of whom were operated on for an intra-abdominal infection. 57 Patients with no sig n of infection served as controls. Main outcome measures: Concentratio ns of 24 biochemical variables measured in specimens of peritoneal flu id obtained during the operation. Results: Major differences between s pecimens taken from infected and uninfected patients including: glucos e 5.4 compared with 0.8 mmol/l, lactate 7.9 and 17.2 mmol/l, aspartate aminotransferase 83 and 520 U/l and gamma-glutamyl transferase 57 and 169 U/l. Conclusion: Intra-abdominal infection significantly alters t he composition of peritoneal fluid. The assessment of milieu factors a t the site of infection may help in the design of more predictive in v itro tests to guide antimicrobial treatment of intra-abdominal infecti ons. In addition, the knowledge of discriminatory variables in periton eal fluid may be useful in the diagnosis of intra-abdominal infection.