PMID- 17823485
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20220331
IS  - 0971-9784 (Print)
IS  - 0971-9784 (Linking)
VI  - 8
IP  - 1
DP  - 2005 Jan
TI  - Blood lactate levels during cardiopulmonary bypass for valvular heart surgery.
PG  - 39-44
AB  - Cardiopulmonary bypass (CPB) is widely used to maintain systemic perfusion and 
      oxygenation during open-heart surgery. Tissue hypoperfusion with resultant lactic 
      acidosis during CPB, may occur during hypothermia, extreme haemodilution, low 
      flow CPB, and excessive neurohormonal activation. There has been no documentation 
      of the correlation between blood lactate level elevations in the perioperative 
      period, and its relation to preoperative New York Heart Association (NYHA) 
      classification and the use of ionotropic support during weaning from CPB, 
      duration of postoperative ventilatory support and perioperative mortality. We 
      studied the perioperative blood lactate levels in 82 patients undergoing valvular 
      heart surgery. Arterial blood samples were collected at different stages of CPB. 
      The observed mean baseline lactate levels were 1.9+/-0.8 mmol/L (normal range of 
      0.9 to 1.7 mmol/L). The mean circulating lactate levels at 15 min and 45 min 
      after institution of CPB increased to 7.01+/-2.6 mmol/L and 9.92+/-3.5 mmol/L. A 
      progressive decline in the mean lactate level, was seen during rewarming (at 35 
      degrees C), immediately off-bypass, 24 hours and 48 hours postoperatively with 
      mean lactate levels being 7.01+/-3.2 mmol/L, 4.75+/-1.01 mmol/L, 3.06+/-1.1 
      mmol/L, and 2.10+/-1.05 mmol/L respectively. Comparison of mean lactate levels in 
      NYHA class I, II, III, and IV patients showed that in the intraoperative period 
      and immediately after CPB, the elevation in lactate levels were statistically 
      significant (p< 0.001) in patients in NYHA Class IV. However the values, in all 
      classes, were similar at 24 and 48 hours after CPB. Also, patients with lactate 
      levels >4 mmol/ L required prolonged inotropic and ventilatory support.
FAU - Shinde, Santosh B
AU  - Shinde SB
AD  - Department of Biochemistry, Lokmanya Tilak Municipal Medical College and 
      Hospital, Sion, Mumbai, India.
FAU - Golam, Kumud K
AU  - Golam KK
FAU - Kumar, Pawan
AU  - Kumar P
FAU - Patil, Neela D
AU  - Patil ND
LA  - eng
PT  - Journal Article
PL  - India
TA  - Ann Card Anaesth
JT  - Annals of cardiac anaesthesia
JID - 9815987
EDAT- 2007/09/08 09:00
MHDA- 2007/09/08 09:01
CRDT- 2007/09/08 09:00
PHST- 2007/09/08 09:00 [pubmed]
PHST- 2007/09/08 09:01 [medline]
PHST- 2007/09/08 09:00 [entrez]
PST - ppublish
SO  - Ann Card Anaesth. 2005 Jan;8(1):39-44.