Evaluation of Serial Arterial Lactate Levels as a Predictor of Hospital and Long-Term Mortality in Patients After Cardiac Surgery

Journal of Cardiothoracic and Vascular Anesthesia
J C Lopez-DelgadoJ L Ventura

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

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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
Aug 12, 2020·Journal of Cardiothoracic Surgery·Darren MullaneGeorgina Flood
May 26, 2021·Brazilian Journal of Otorhinolaryngology·Suzane Pereira de SouzaTercio Guimarães Reis

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