Lactate and base deficit are predictors of mortality in critically ill patients with cancer

Hajjar, Ludhmila Abrahão; Nakamura, Rosana Ely; Almeida, Juliano Pinheiro de; Fukushima, Júlia Tizue; Hoff, Paulo M.; Vincent, Jean‐Louis; Júnior, José Otávio Costa Auler; Galas, Filomena Regina Barbosa Gomes

doi:10.1590/s1807-59322011001200007

Cited by 28 publications

(17 citation statements)

References 20 publications

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“…The prevalence of patients with a lower preoperative left ventricular ejection fraction (LVEF) was higher in the group with complications as compared with the group without complications (LVEF<40%, 16 [31%] vs 53 [12%]; P ¼ .001). Patients with complications also had a higher operative risk, characterized by a higher EuroSCORE (7 [5][6][7][8][9] vs 4 [3][4][5][6]; P < .001) and a lower preoperative hemoglobin level (12.6 AE 2.1 vs 13.3 AE 1.7 gm/dL; P ¼ .009) when compared with patients without complications ( Table 1). The group with complications had a longer duration of hospital stay (14 AE 5 days vs 9 AE 4 days; P <.001) than those who did not.…”

Section: Resultsmentioning

confidence: 99%

“…14,15 Polonen and associates 16 showed that normalizing lactate concentrations as a therapeutic goal is associated with decreased morbidity and hospital length of stay in patients undergoing cardiac surgery. Although some studies have described lactate levels higher than 3 mmol/L as being associated with worse outcomes in critically ill surgical patients, 6,17 other investigations have discussed which is the appropriate range for lactate values in these patients. 18,19 This study has shown that lactate concentrations higher than 3 mmol/L 6 hours after ICU admission are independently associated with major complications after cardiac surgery, including death.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] In sepsis and shock states, high levels of blood lactate have been associated with worse outcomes, including mortality. 5,6 After cardiac surgery, morbidity and mortality are related directly to the preoperative status of the patient, as well as to specific anesthetic, surgical, and postoperative factors. The maintenance of appropriate hemodynamic goals is essential to improve outcomes after cardiac surgery.…”

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confidence: 99%

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High lactate levels are predictors of major complications after cardiac surgery

Hajjar

Almeida

Fukushima

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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High lactate levels are predictors of major complications after cardiac surgery

Hajjar

Almeida

Fukushima

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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136

100

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“…The combination of ketamine, midazolam, and fentanyl for the induction of anesthesia provided better hemodynamic stability during induction and until the end of sternotomy in patients undergoing coronary artery bypass grafting surgery. Hajjar et al [58] evaluated whether arterial lactate or standard base deficit on admission and after 24 hours can predict mortality for patients with cancer. They evaluated 1,129 patients with severe sepsis, septic shock, or postoperative after highrisk surgery.…”

Section: Kk and Rocha E Silva M -Cardiology In Brazilian Scientific Joumentioning

confidence: 99%

Cardiology in Brazilian scientific journals: an overview

Patel

Silva

2012

Rev Bras Cir Cardiovasc

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Cardiology has been and is a very significant fraction of the Brazilian contribution to science. In older days, the most significant part of this work was directed to foreign periodicals, but the quasi-simultaneous emergence of SciELO and PUBMED has ordained a redirection of much of this work to Brazilian periodicals. We here survey some of this more recent contribution for the benefit of readers of Revista Brasileira de Cirurgia Cardiovascular. This is offered as an update. Articles on the general themes of Cardiology and Pneumology published by four ISI Indexed Brazilian journals not specializing in cardiology are re-visited, after a search through 10 journals. ResumoA Cardiologia foi, e continua sendo, responsável por uma fracção muito significativa da contribuição brasileira para a ciência. No passado, os trabalhos mais importantes eram direcionados para periódicos estrangeiros, mas o surgimento quase simultâneo do SciELO e PUBMED facilitou um redirecionamento de grande parte desses trabalhos a periódicos brasileiros. Neste artigo, examinamos algumas das contribuições mais recentes em benefício aos leitores da Revista Brasileira de Cirurgia Cardiovascular. Esta discussão é oferecida como uma atualização. Artigos sobre os temas gerais da cardiologia e pneumologia publicados por quatro revistas brasileiras indexadas no ISI -não especializadas em cardiologia -são revistos.RBCCV

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“…So, our IHD patients are not representative of the whole ICU population. Around 30% of patients treated at ICESP ICU required mechanical ventilation and vasopressors in a series reported by Hajjar LA et al [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Intermittent Hemodialysis in Critically Ill Cancer Patients with Acute Kidney Injury Using Single-Pass Batch Equipment

et al. 2016

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BackgroundData on renal replacement therapy (RRT) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) is scarce. The aim of this study was to assess the safety and the adequacy of intermittent hemodialysis (IHD) in critically ill cancer patients with AKI.Methods and FindingsIn this observational prospective cohort study, 149 ICU cancer patients with AKI were treated with 448 single-pass batch IHD procedures and evaluated from June 2010 to June 2012. Primary outcomes were IHD complications (hypotension and clotting) and adequacy. A multiple logistic regression was performed in order to identify factors associated with IHD complications (hypotension and clotting). Patients were 62.2 ± 14.3 years old, 86.6% had a solid cancer, sepsis was the main AKI cause (51%) and in-hospital mortality was 59.7%. RRT session time was 240 (180–300) min, blood/dialysate flow was 250 (200–300) mL/min and UF was 1000 (0–2000) ml. Hypotension occurred in 25% of the sessions. Independent risk factors (RF) for hypotension were dialysate conductivity (each ms/cm, OR 0.81, CI 0.69–0.95), initial mean arterial pressure (each 10 mmHg, OR 0.49, CI 0.40–0.61) and SOFA score (OR 1.16, CI 1.03–1.30). Clotting and malfunctioning catheters (MC) occurred in 23.8% and 29.2% of the procedures, respectively. Independent RF for clotting were heparin use (OR 0.57, CI 0.33–0.99), MC (OR 3.59, CI 2.24–5.77) and RRT system pressure increase over 25% (OR 2.15, CI 1.61–4.17). Post RRT blood tests were urea 71 (49–104) mg/dL, creatinine 2.71 (2.10–3.8) mg/dL, bicarbonate 24.1 (22.5–25.5) mEq/L and K 3.8 (3.5–4.1) mEq/L.ConclusionIHD for critically ill patients with cancer and AKI offered acceptable hemodynamic stability and provided adequate metabolic control.

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Lactate and base deficit are predictors of mortality in critically ill patients with cancer

Cited by 28 publications

References 20 publications

High lactate levels are predictors of major complications after cardiac surgery

High lactate levels are predictors of major complications after cardiac surgery

Cardiology in Brazilian scientific journals: an overview

Evaluation of Intermittent Hemodialysis in Critically Ill Cancer Patients with Acute Kidney Injury Using Single-Pass Batch Equipment

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