Serum Lactate Level Has Prognostic Significance After Pediatric Cardiac Surgery

Başaran, Murat; Sever, Kenan; Kafali, Eylül; Uğurlucan, Murat; Sayın, Ömer Ali; Tansel, Turkan; Alpagut, Ufuk; Dayıoğlu, Enver; Onursal, Ertan

doi:10.1053/j.jvca.2004.10.010

Cited by 90 publications

(59 citation statements)

References 18 publications

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“…Postoperative hyperlactatemia as a result of tissue hypoperfusion is associated with high morbidity and mortality, and the serum or plasma lactate level in the intensive care unit (ICU) has prognostic value after pediatric cardiac surgery (Cheifetz et al 1997;Charpie et al 2000, Cheung et al 2005, Basaran et al 2006). In addition, hyperlactatemia during cardiopulmonary bypass (CPB) is an early predictor of morbidity and mortality in pediatric patients (Munoz et al 2000, Ranucci et al 2006.…”

mentioning

confidence: 99%

Intraoperative Plasma Lactate as an Early Indicator of Major Postoperative Events in Pediatric Cardiac Patients

Park

Kim

Byon

et al. 2012

Tohoku J. Exp. Med.

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Hyperlactatemia and unmeasured anions (UMA) have been suggested to be useful predictors of outcomes after pediatric cardiac surgery in the ICU. However, if we detect high-risk patient in the operating room, we could practice early intervention to decrease mortality and morbidity. The purpose of this study was to determine whether the intraoperative lactate or UMA levels can predict adverse outcomes in pediatric cardiac patients with undergoing cardiopulmonary bypass (CPB). We studied 102 patients with congenital heart disease. Arterial blood samples were obtained after inducing anesthesia, 5 min after weaning from CPB and after chest closure. Major adverse events (MAEs) were defined as cardiac compression, re-sternotomy due to hemodynamic instability, extra-corporeal membrane oxygenator support, creatinine levels greater than 2 mg/dL, or death. Patients were divided into MAE group (8 patients, 7.8%) and non-MAE group. Six patients with MAEs died. Importantly, the lactate levels (mmol/L) at weaning from CPB (4.19 vs 2.1; MAE group vs non-MAE group), chest closure (5.76 vs 2.39; MAE group vs non-MAE group) and the intraoperative increases in lactate levels were significantly higher in the MAE group than in the non-MAE group. However, there was no significant difference in the UMA levels or their changes between the groups. The increase in the lactate level from CPB weaning to chest closure was the best predictor of MAEs (AUC: 0.810). In conclusion, the intraoperative plasma lactate levels were more closely associated with MAEs, and they are more useful for predicting the outcome of pediatric cardiac patients than the UMA levels.

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mentioning

confidence: 99%

Intraoperative Plasma Lactate as an Early Indicator of Major Postoperative Events in Pediatric Cardiac Patients

Park

Kim

Byon

et al. 2012

Tohoku J. Exp. Med.

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“…Patients with higher lactate clearance (>10%) within the first six hours were found to have improved postoperative outcomes and were found to be associated with decreased mortality rates. In another study, Basaran et al [19] found that 26 of 60 patients (43.3%) had a mean serum lactate >4.8 mmol/L. Six patients died in the postoperative period, and all of these patients were in the high lactate group.…”

Section: Discussionmentioning

confidence: 94%

“…[3][4][5]8,[17][18][19] Cheifetz et al [3] reported that six of 48 patients who underwent high risk open-heart surgery died. The patients in the group in which the patients died had significantly higher lactate levels in the postoperative period than that of survivors.…”

Section: Discussionmentioning

confidence: 99%

Correlation between serum lactate levels and outcome in pediatric patients undergoing congenital heart surgery

Şahutoğlu

Yaşar

Kocabas

et al. 2018

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada doğuştan kalp cerrahisi geçiren pediatrik hastalarda perioperatif arteriyal laktat düzeyleri ile mortalite ve morbidite arasında ilişki olup olmadığı araştırıldı.Ça lış m a pla nı: Haziran 2014-Mayıs 2016 tarihleri arasında doğuştan kalp cerrahisi geçiren 236 hasta (121 erkek, 115 kadın; ort. yaş 56.4 ay (median: 42 ay): dağılım, 1 gün-204 ay) retrospektif olarak değerlendirildi. Başlangıçta (arter kanülü uygulandıktan sonra), kardiyopulmoner baypas soğuma ve ısınma fazında, sternum kapatılması aşamasında ve ameliyat sonrası yoğun bakım kalış süresi 0, 6, 12. ve 24. saatlerdeki arteriyel kan gazı analizleri kaydedildi. Hastalar laktat düzeylerine göre iki gruba ayrıldı: (Grup 1 laktat düzeyi <4.5 mmol/L, n=183; Grup 2 laktat düzeyi ≥4.5 mmol/L, n=53). Gruplar ile hastaların demografik verileri, ameliyat sırası ve ameliyat sonrası değişkenler, komplikasyonlar ve mortalite arasındaki ilişki araştırıldı. Bul gu lar:Altmış dokuz hastada (%29.2) siyanotik kalp hastalığı vardı. Toplamda 53 hastada (%22.5) laktat düzeyi 4.5 mmol/L ve üzerinde idi. Hastaların %41'inde en az bir komplikasyon gelişti. Laktat düzeyi ≥4.5 mmol/L grupta en az bir komplikasyon gelişimi (p= 0.027) ve mortalite oranı (p<0.001) anlamlı olarak daha yüksekti. On yedi hasta (%7.2) ameliyat sonrası dönemde kaybedildi ve bu hastaların 15'inde laktat düzeyi ilk 24 saatte en az bir kez ≥4.5 mmol/L idi. Herhangi bir dönemde laktat düzeylerinin ≥4.5 mmol/L olması, uzamış mekanik ventilasyon (>48 saat) ve hastanın kompleks cerrahi geçirmesi (yüksek Risk-adjusted Classification for Congenital Heart Surgery-1 skoru, kategori 4-6) mortalite için bağımsız risk faktörü olarak tespit edildi.So nuç:Doğuştan kalp cerrahisi uygulanan çocuk hastalarda, arteriyel laktat düzeyinin 4.5 mmol/L veya üzerinde olmasının ameliyat sonrası morbidite ve mortalite için bağımsız risk faktörü olduğu saptandı.Anah tarsöz cük ler: Kardiyak cerrahi; doğuştan; kalp kusurları; laktat; ölüm oranı; ameliyat sonrası komplikasyonlar ABSTRACT Background: This study aimed to investigate the correlation between perioperative arterial lactate levels and morbidity and mortality in children undergoing cardiac surgery.

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“…There was a significant relation between mean age and mortality (p=0.008). Mean (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) hours in the HL group. There was a significant relation between increased MVD and mortality (p=0.006).…”

Section: Resultsmentioning

confidence: 99%

The Relationship of Hyperlactatemia Following Paediatric Open Heart Surgery with Mortality, Morbidity and Risk Factors

Oğuz¹,

Bozoglan²,

Serhatlıoğlu³

et al. 2014

Erciyes Med J

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Objective: In this present study, the association of hyperlactatemia frequency with probable risk factors, postoperative morbidity and mortality were investigated in patients undergoing paediatric open heart surgery. Materials and Methods:The present study included 45 consecutive paediatric patients who had undergone open heart surgery with hypothermic cardiopulmonary bypass in the cardiovascular surgery clinic between January 2008 and July 2008. Four blood samples for lactate analysis were collected from each of the patients preoperatively, intraoperatively and at 1 and 12 hours postoperatively. The patients were divided into two groups according to blood lactate levels as the high lactate group (mean lactate level≥ 3 mmol/L) and the normal lactate group (mean lactate level <3 mmol/L). Hyperlactatemia frequency, associated risk factors, and the relationship with morbidity and mortality were statistically analysed.Results: Of 45 cases, 33 (73.3%) were included in the normal lactate (NL) group, and 12 (26.7%) were included in the high lactate (HL) group. A borderline association was found between lactate levels and mortality in the HL group (p=0.052). Body surface area, age, low cardiac output syndrome, intraoperative and postoperative inotropic support requirement, duration of mechanical ventilation were determined as risk factors associated with mortality (p<0.05), and low cardiac output syndrome, urine output and metabolic acidosis were determined as risk factors associated with hyperlactatemia (p<0.05). Conclusion:In patients followed up in the intensive care unit, lactate concentration is a good indicator for disease severity. Blood lactate levels seems to be a parameter that can be used in routine follow-up.

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Serum Lactate Level Has Prognostic Significance After Pediatric Cardiac Surgery

Cited by 90 publications

References 18 publications

Intraoperative Plasma Lactate as an Early Indicator of Major Postoperative Events in Pediatric Cardiac Patients

Intraoperative Plasma Lactate as an Early Indicator of Major Postoperative Events in Pediatric Cardiac Patients

Correlation between serum lactate levels and outcome in pediatric patients undergoing congenital heart surgery

The Relationship of Hyperlactatemia Following Paediatric Open Heart Surgery with Mortality, Morbidity and Risk Factors

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