Initial postoperative serum lactate levels predict survival in children after open heart surgery

Abstract

Initial postoperative serum lactate levels after pediatric open heart surgery may be predictive of outcome. Lactate levels are also higher in patients who go on to develop multiple organ system failure. Elevated postoperative lactate levels may reflect intraoperative tissue hypoperfusion, and measures aimed at increasing oxygen delivery, with normalization of lactate, may improve patient outcome.

The impact of hyperlactatemia on postoperative outcome after adult cardiac surgery

“…Irrespective of the origin of increased blood lactate levels, hyperlactatemia in septic [17], trauma [18], and emergency department patients [15,16] is always associated with unfavorable outcome, compared to similar patients with normal blood lactate levels. Several studies have demonstrated that hyperlactatemia in the early postoperative period following pediatric cardiac surgery [3,4,[19][20][21][22] and adult cardiac surgery [1] is associated with an increased risk of mortality and morbidity. The link between tissue hypoperfusion and hyperlactatemia is evident.…”

A decreased serum concentration of nitrite/nitrate correlates with an increased plasma concentration of lactate during and after major surgery

“…Siegel et al reported the postoperative lactate level to reflect intraoperative tissue hypoperfusion. 4 Schlichting et al employed the plasma lactate level as a conventional marker of tissue hypoxia. 5 Based on these studies, the plasma lactate concentration seems to be one of the indicators of tissue perfusion.…”

The strong ion gap predicts mortality in children following cardiopulmonary bypass surgery*

“…Prolonged or severe tissue hypoxia is thought to play a key role and may be reflected by an elevated blood lactate concentration. The association between hyperlactatemia and poor outcome is well documented (1)(2)(3)(4)(5); however, these studies have failed collectively to identify a single, consistent value for lactate that is most predictive (4). This may be due to confounding factors that influence blood lactate concentration independently from tissue hypoxia.…”