Frequency, Risk Factors, and Outcome of Hyperlactatemia After Cardiac Surgery

Maillet, J; Besnerais, P. Le; Cantoni, M D Alessandra; Nataf, Patrick; Ruffenach, Alain; Lessana, A; Brodaty, D

doi:10.1378/chest.123.5.1361

Cited by 235 publications

(266 citation statements)

References 20 publications

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“…In current study, operation time is found as a risk factors causing postoperative high lactate and is statistically significant. 4,7 The present study also showed that the difference between two groups is statistically significant in prolong mechanical ventilation. Maillet et al (2003) showed in previous study that prolong mechanical ventilation and ICU stay found in hyperlactatemia group after cardiac surgery.…”

Section: Discussionsupporting

confidence: 72%

“…4,7 The present study also showed that the difference between two groups is statistically significant in prolong mechanical ventilation. Maillet et al (2003) showed in previous study that prolong mechanical ventilation and ICU stay found in hyperlactatemia group after cardiac surgery. 4 In this study in case of low output syndrome and arrhythmia the difference between the two groups are statistically significant.…”

Section: Discussionsupporting

confidence: 72%

“…8,10 In our study we evaluate the outcome variables for major adverse outcome and found neurological deficit, pulmonary complication and renal dysfunction have statistically significant differences between groups, Nichol et al (2010) showed a strong positive correlation between blood lactate levels and the risk of morbidity and mortality with neurological deficits.11 Hajjar et al (2013), Malliet et al (2003) and Ranucci et al (2006) showed in their studies a strong correlation between high lactate and major complications after cardiac surgery that are similar with current study. 4,5,9 In our study, binary logistic regression analysis shows that blood lactate level 6 hours after ICU transfer is an independent predictor for prolonged mechanical ventilation time, prolonged ICU stay, neurological deficit, pulmonary complication, arrhythmia, renal dysfunction and mortality. The results of this study and discussion thereof prompt us to recommend that routine lactate level measurement is essential for postoperative cardiac ICU to detect early adverse outcome.…”

Section: Discussionmentioning

confidence: 48%

“…Maillet et al (2003) showed in previous study that prolong mechanical ventilation and ICU stay found in hyperlactatemia group after cardiac surgery. 4 In this study in case of low output syndrome and arrhythmia the difference between the two groups are statistically significant. Rao et al (2001) and Arnold et al (2009) stated that the development of postoperative LOS and cardiovascular complications in the absence of an intraoperative misadventure revealed a failure of myocardial protection causing persistent anaerobic metabolism and lactate release.…”

Section: Discussionmentioning

confidence: 85%

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Blood Lactate Level as Predictor of Early Outcome after Cardiac Surgery under Cardiopulmonary Bypass

et al. 2018

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We examined the hypothesis that high blood lactate level in ICU patient after adult cardiac surgery under cardiopulmonary bypass is associated with early adverse outcome. The objective of this study was to evaluate whether blood lactate level after cardiac surgery is predictor of the early outcome after adult cardiac surgery under CPB. In this prospective observational study total 100 patients were enrolled who underwent elective cardiac surgery under CPB as per inclusion and exclusion criteria. Blood lactate levels > 3mmol/ L 6 hours after ICU transfer were present in 57(57%) patients. The binary logistic regression analysis showed that blood lactate level 6 hours after ICU transfer is an independent predictor for prolonged mechanical ventilation time (OR 2.417, 95% CI 1.272 - 4.596, p = .007), prolonged ICU stay (OR 1.562, 95% CI 1.181 - 2.067, p = .002), neurological deficit (OR 2.432, 95% CI 1.539 - 3.843, p = .001), pulmonary complication (OR 1.301, 95% CI 1.011 - 1.676, p = .041), arrhythmia (OR 1.444, 95% CI 1.102 - 1.893, p = .008), renal dysfunction (OR 1.838, 95% CI 1.352 - 2.497, p = .001) and mortality (OR 1.822, 95% CI 1.123- 2.955, p = .015). In conclusion, blood lactate level 6 hours after ICU transfer is an independent risk factor for worse outcomes in adult patients including mortality after cardiac surgery under CPB.University Heart Journal Vol. 13, No. 2, July 2017; 50-54

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Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 85%

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Blood Lactate Level as Predictor of Early Outcome after Cardiac Surgery under Cardiopulmonary Bypass

et al. 2018

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“…O aumento da mortalidade tem sido observado em pacientes que apresentam níveis de lactato sérico acima de 22 mg/dl 19 30 . Em crianças após cirurgia cardíaca, a duração da circulação extracorpórea e o nível de lactato, medidos no pós-operatório imediato, foram os melhores preditores para o risco de aparecimento de complicações clínico-cirúrgicas nas primeiras 48 horas de pós-operatório e também com relação ao óbito 29 .…”

Section: Discussionunclassified

Blood lactate concentration as prognostic marker in critically ill children

Koliski¹,

Cat²,

Giraldi³

et al. 2005

J Pediatr (Rio J)

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Objective: To assess the use of lactate as a marker of tissue hypoperfusion and as a prognostic index in critically ill patients.Methods: Prospective, longitudinal, observational study of 75 patients admitted to the pediatric ICU of Hospital de Clínicas of Universidade Federal do Paraná, between November 1998 and May 1999. According to the lactate level on admission, patients were divided into group A (lactate > 18 mg/dl) and group B (lactate < 18 mg/dl). In terms of outcome, patients were classified into survivors and nonsurvivors. In group A, the clinical evaluation and the collection of arterial blood samples were performed on admission, at 6, 12, 24, 48 hours, and every 24 hours after that. In group B, they were carried out in the same way, but interrupted 48 hours after admission.Results: Groups A and B consisted of 50 and 25 patients, respectively. Group A presented more clinical signs of hypoperfusion (24/50). There was a statistically significant difference regarding the mean lactate levels on admission between those patients who died within 24 hours of admission (95 mg/dl) and those who died 24 hours after admission (28 mg/dl). The lactate level at 24 hours of admission revealed better sensitivity (55.6%) and specificity (97.2%) as a predictor of death.Conclusions: Most patients with lactate levels > 18 mg/dl showed clinical signs of hypoperfusion on admission. The normalization or reduction of lactate levels at and after 24 hours of admission was significantly related with higher chances of survival. J Pediatr (Rio J)

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Fluid Management, Renal, Metabolic, and Endocrine Problems

2020

Manual of Perioperative Care in Adult Cardiac Surgery

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Frequency, Risk Factors, and Outcome of Hyperlactatemia After Cardiac Surgery

Cited by 235 publications

References 20 publications

Blood Lactate Level as Predictor of Early Outcome after Cardiac Surgery under Cardiopulmonary Bypass

Blood Lactate Level as Predictor of Early Outcome after Cardiac Surgery under Cardiopulmonary Bypass

Blood lactate concentration as prognostic marker in critically ill children

Fluid Management, Renal, Metabolic, and Endocrine Problems

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