Anestéziológia a intenzívna medicína 2/2016

Lactate and its clearance as a marker of shock after cardiac surgery procedures

Goal of the study: To confirm lactate and its clearance as a marker of shock using following observed parameters: sum of the lactate, maximal lactate value, duration of hyperlactatemia and lactate clearance after cardiac surgery procedures. Material and methods: 130 pacients undergoing cardiac surgery with cardiopulmonary bypass were divided into 2 groups based on the measured postoperative hyperlactatemia (experimental and control group). The first step of analysis was to compare both groups based on the preoperative Euroscore II, postoperative SOFA score, number of complications, duration of controlled ventilation, duration of hospital stay in the intensive care unit, VUSCH, a.s., rehospitalization, type of hospital discharge and mortality. The second step was to analyze the followed group. Followed group was analyzed based on the sum of the lactate, maximal lactate value, duration of hyperlactatemia and lactate clearance according to previously mentioned 9 followed parameters. Results: Both groups statistically significantly differed in three followed parameters of Euroscore II, SOFA score and duration of controlled ventilation (p<0.05). The analysis of the followed group showed that based on the sum of lactate patients differed in duration of hospital stay in VUSCH, a.s., based on the maximal lactate value patients differed in Euroscore II and duration of hospital stay in VUSCH, a.s. and based on the lactate clearance patients differed in SOFA score and duration of hospital stay in VUSCH, a.s. Conclusion:Despite certain lactate limitations we have confirmed that lactate is a marker of shock after cardiac surgery procedures in some of the followed parameters. To achieve more significant results a higher number of patients in the study group would be probably needed in the future.

Keywords: lactate, lactate clearance, shock, cardiac surgery