Abstract
Although hyperlactatemia is common after cardiac surgery, its value as a prognostic marker is unclear. The aim of the present study was to determine whether postoperative serial arterial lactate (AL) measurements after cardiac surgery could predict outcome. Prospective, observational study. Surgical intensive care unit in a tertiary-level university hospital. Participants included 2,935 consecutive patients. AL was measured on admission to the intensive care unit and 6, 12, and 24 hours after surgery, and evaluated together with clinical data and outcomes including in-hospital and long-term mortality. In-hospital and long-term mortality (mean follow-up 6.3±1.7 years) were 5.9% and 8.7%, respectively. Compared with survivors, nonsurvivors showed higher mean AL values in all measurements (p<0.001). Hyperlactatemia (AL>3.0 mmol/L) was a predictor for in-hospital mortality (odds ratio = 1.468; 95% confidence interval = 1.239-1.739; p<0.001) and long-term mortality (hazard ratio = 1.511; 95% confidence interval = 1.251-1.825; p<0.001). Recent myocardial infarction and longer cardiopulmonary bypass time were predictors of hyperlactatemia. The pattern of AL dynamics was similar in both groups, but nonsurvivors showed higher AL values,...Continue Reading
References
Mar 1, 1990·Critical Care Medicine·T J IbertiE P Fischer
Feb 1, 1990·Diabetes Care·J P Le FlochL Perlemuter
Jun 1, 1970·Circulation·M H Weil, A A Afifi
Nov 14, 1997·The Annals of Thoracic Surgery·T L HigginsD M Cosgrove
Aug 9, 2001·Coronary Artery Disease·H A Cooper, E Braunwald
Sep 13, 2001·European Journal of Anaesthesiology·S InoueH Furuya
May 13, 2003·Chest·Jean-Michel MailletDenis Brodaty
May 18, 2005·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ardawan Julian RastanFriedrich Wilhelm Mohr
Oct 11, 2005·Critical Care Medicine·Jean-Pierre RevellyRené L Chioléro
Sep 4, 2007·Psychosomatic Medicine·Desta B FekedulegnDiane B Miller
Oct 2, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hrvoje GasparovicIvan Jelic
Mar 25, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Nouredin MessaoudiInez E R Rodrigus
Aug 4, 2010·Circulation·Roelof G A EttemaKarel G M Moons
Jan 25, 2011·Journal of Critical Care·Deven JunejaRohit Dang
Mar 3, 2011·Journal of Cardiothoracic Surgery·Fabian DoerrKhosro Hekmat
Aug 16, 2011·Transplantation Proceedings·J A Noval-PadilloJ M Guerrero-Montavez
Sep 20, 2011·Journal of Cardiothoracic and Vascular Anesthesia·BeeBee Y HuR Thomas Solis
Nov 25, 2011·Journal of Anesthesia·Alexander KoganEhud Raanani
Sep 11, 2012·The Annals of Thoracic Surgery·Aaron J LindsayC Allen Bashour
Dec 18, 2012·Interactive Cardiovascular and Thoracic Surgery·Juan Carlos Lopez-DelgadoJosep Lluís Ventura
Mar 20, 2013·The Journal of Thoracic and Cardiovascular Surgery·Ludhmila A HajjarFilomena R B G Galas
Oct 22, 2013·The Journal of Thoracic and Cardiovascular Surgery·Kurt R SchumacherJohn R Charpie
Dec 18, 2013·Critical Care : the Official Journal of the Critical Care Forum·Juan C Lopez-DelgadoRafael Manez
Apr 8, 2014·The Lancet. Diabetes & Endocrinology·Mercedes Garcia-AlvarezRinaldo Bellomo
Citations
Aug 16, 2016·Critical Care : the Official Journal of the Critical Care Forum·Jean-Louis VincentFabio S Taccone
Aug 21, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Marco C HaanschotenMohamed A Soliman Hamad
Mar 10, 2017·Anesthesia and Analgesia·Lars W Andersen
Oct 6, 2018·PloS One·Bjoern ZanteCarmen A Pfortmueller
Jan 22, 2019·European Journal of Anaesthesiology·Mouhamed D MoussaEmmanuel Robin
Aug 12, 2020·Journal of Cardiothoracic Surgery·Darren MullaneGeorgina Flood
Jun 30, 2019·Perfusion·Benoit DuvalAlexandre Ouattara
Feb 20, 2020·PeerJ·Anna KędzioraBoguslaw Kapelak
Jun 13, 2020·JA Clinical Reports·Mariko EzakaKazue Yamaoka
Feb 27, 2020·Perfusion·Matteo MatteucciCesare Beghi
May 26, 2021·Brazilian Journal of Otorhinolaryngology·Suzane Pereira de SouzaTercio Guimarães Reis
Jan 5, 2021·Shock·John C GreenwoodBenjamin S Abella