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:: Volume 20, Issue 6 (Bimonthly 2017) ::
Feyz 2017, 20(6): 518-524 Back to browse issues page
Association between serum lactate and postoperative outcomes following coronary artery bypass graft surgery
Fatemeh Hasanshiri, Mohammad Sadegh Pourabbasi *, Seyyed Gholam Abbas Mousavi, Mojdeh Fatahi, Amir Abbas Kianfar, Hamid Reza Seyedi, Fakhrosadat Mirhoseini, Mehrdad Mahdian
Department of Heart, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, I. R. Iran. , drmpourabbasi@yahoo.com
Abstract:   (2717 Views)

Background: Increased serum lactate during cardio-pulmonary bypass is associated with high mortality and cardiac complications up to 10-20 percent. The aim of this study was to evaluate the effect of serum lactate increase on postoperative outcomes after coronary artery bypass graft (CABG) Surgery.

Materials and Methods: This descriptive-analytical study was performed on cases (no=116) undergoing CABG at Beheshti hospital in Kashan between 2013-2014. Demographic data, variables related to surgery, serum lactate level and the time of tracheal extubation, length of stay in intensive care unit (ICU) and hospital post-surgery left ventricular ejection fraction were collected. These data was compared in two groups: Normal serum lactate (< 2 m molliter) and Hyperlactatemia (> 2 m molliter) group.

Results: The postoperative hyperlactatemia was observed in 62.1 % of patients. There were no significant differences between two groups in time of tracheal extubation, length of stay in ICU and hospital. There was a relationship between the mean postoperative serum lactate and blood sugar, bicarbonate, pH, length of cardiopulmonary bypass and the aortic cross clamping time. There was a significant relationship between the serum lactate increment and the left ventricular ejection fraction decrement.

Conclusion: Hyperlactatemia is probably associated with such important factors as high blood sugar, longer duration of aortic cross clamp and cardio-pulmonary bypass time. So controlling such factors can reduce the rate of hyperlactatemia and help postoperative recovery.

Keywords: Coronary artery bypasses graft, Serum lactate, Cardiopulmonary bypass, Postoperative outcomes
Full-Text [PDF 224 kb]   (808 Downloads)    
Type of Study: Research | Subject: General
Received: 2017/01/2 | Accepted: 2017/01/2 | Published: 2017/01/2
References
1. Babatabar Darzi H, Ebadi A, Karimi Zarchi AA, Sharghi Namin AR, Mokhtari Noori J, Tadrisi SD, et al. Relation between complication of post CABG with during of intubation. Iran J Crit Care Nurs 2009; 2(1): 31-3.
2. Mirmohammad Sadeghi M, Etesampour A, Gharipour M, Saeidi M, Mirmohammad sadeghi P, Kiani A, et al. The Association between Serum Lactate Level and Post CABG Complications in Cardiac Patients. J Isfahan Med Sch 2011; 128(29): 147-4. [in Persian]
3. Javidi D, Ladan M. Pathophysiology of lactic acidosis, and its clinical importance after cardiac surgery. Iran J Cardiac Surg 2008; 2(3): 18-23. [in Persian]
4. Toraman F, Evrenkaya S, Yuce M, Aksoy N, Karabulut H, Bozkulak Y, et al. Lactic Acidosis after Cardiac Surgery Is Associated with Adverse Outcome. Heart Surg Forum 2004; 7(2): 155-9.
5. Maillet JM, Le Besnerais P, Cantoni M, Nataf P, Ruffenach A, Lessana A, et al. Frequency, Risk Factors and Outcome of Hyperlactatemia After Cardiac Surgery. Chest 2003; 123(5): 1361-6.
6. Landow L. Splanchnic lactate production in cardiac surgery patients. Crit Care Med 1993; 21 Suppl 2: 84-91.
7. Boldt J, Piper S, Murray P, Lehmann A. Case 2-1999. Severe lactic acidosis after cardiac surgery: sign of perfusion deficits. J Cardiothorac Vasc Anesth 1999; 13(2): 220-4.
8. Totaro RJ, Raper RF. Epinephrine-induced lactic acidosis following cardiopulmonary bypass. Crit Care Med 1997; 25(10): 1693-9.
9. Yusefnia MA, Masoomi M. Artificial heart and lung during cardiac surgery. Tehran: Nashre Jahad; 1995. p. 47. [in Persian]
10. Kogan A, Preisman S, Bar A, Sternik L, Lavee J, Malachy A, et al. The impact of hyperlactatemia on post operative outcome after adult cardiac surgery. J Anesth 2012; 26(2): 174-8.
11. Chandrasena LG, Peiris H, Waikar HD. Biochemical changes associated with reperfusion after off-pump and on-pump coronary artery bypass graft surgery. Ann Clin Lab Sci 2009; 39(4): 372-7.
12. Pagana KD. Manual of diagnostic and laboratory test. 3th ed. Mosby; 2006. p. 337. [in Persian]
13. Ranucci M, De Toffol B, Isgrò G, Romitti F, Conti D, Vicentini M. Hyperlactatemia during cardiopulmonary bypass: determinants and impact on postoperative outcome. Crit Care 2006; 10(6): R167.
14. Demers P, Elkouri S, Martineau R, Couturier A, Cartier R. Outcome with high blood lactate levels during cardiopulmonary bypass in adult cardiac operation. Ann Thorac Surg 2000; 70(6): 2082-6.
15. Azarfarin R, Bilehjani I, Kianfar AA, Mirinejad M, Alizadeh Asl A. Diagnostic value of “base deficit” in arterial blood gas analysis in comparison with hyperlactatemia as an indicator of tissue hypoperfusion in cardiac surgery. Iran South Med J 2009; 12(2): 119-5. [in Persian]
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Hasanshiri F, Pourabbasi M S, Mousavi S G A, Fatahi M, Kianfar A A, Seyedi H R, et al . Association between serum lactate and postoperative outcomes following coronary artery bypass graft surgery . Feyz. 2017; 20 (6) :518-524
URL: http://feyz.kaums.ac.ir/article-1-3225-en.html


Volume 20, Issue 6 (Bimonthly 2017) Back to browse issues page
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