Clinical Chemistry and Laboratory Medicine

Biography

Biography: Peter Kelbich

Abstract

An impairment of an organ system is usually associated with a local inflammatory response. It is projected into the composition of a particular extravascular fluid. Specification of a local inflammation is important for an accurate diagnosis of a particular organ.

We use the cytological-energetic principle for the extravascular body fluids examination. The first step is specification of its cellular composition. The second step is the specification of local immunocompetent cells activation via the evaluation of glucose metabolism.

       We derived the so-called Coefficient of Energy Balance (KEB):

                                 KEB = 38 – 18 . [lactate]/ [glucose]

This parameter is calculated from molar concentrations of glucose and lactate in the extravascular fluid. It’s defined as the theoretical average number of molecules of adenosine triphosphate produced from one molecule of glucose under given conditions in the particular compartment.

Summary:

1. KEB values >28.0 indicate normal energy conditions in the extravascular fluid but cannot rule out a possible pathological process in the particular organ.
2. KEB values from 15.0 to 28.0 indicate increased anaerobic metabolism in the extravascular fluid, which is usually associated with local slide serous inflammation.
3. KEB values <10.0 indicate a very high level of anaerobic metabolism in the extravascular fluid, usually related to severe local inflammation with an oxidative burst of phagocytes. We distinguish purulent inflammation with oxidative burst of the neutrophil phagocytes, usually involving extracellular bacteria or intensive inflammation with oxidative burst of macrophages, involving intracellular bacteria, mycotic agents or cancer.