Department of Anaesthesia & Critical Care, Harefield Hospital, Royal Brompton & Harefield NHS Foundation Trust, Uxbridge, UB9 6JH, UK.
Department of Anaesthesia & Critical Care, National Institute of Cardiology, Warsaw, 04-628, Poland.
Biomark Med. 2022 Jun;16(8):599-611. doi: 10.2217/bmm-2021-1041. Epub 2022 Mar 24.
Hyperlactatemia is common post-heart transplantation. Lactate measurements in the first 24 h were analyzed with respect to mortality. A total of 153 consecutive cardiac transplant patients were reviewed. Recipients of organs maintained in a state of perfusion were included. A total of 143 heart recipients were included. Hyperlactatemia (>2 mmol/l) was present in all patients. Despite maximum lactate and lactate clearance being significantly higher in nonsurvivors (p = 0.002, p = 0.004), neither receiver operator curve analysis nor multivariate logistic regression showed association with 1-year mortality. In comparison, the minimum lactate was significantly associated with mortality (area under the curve 0.728 [p < 0.001]; odds ratio 1.28 [95% 1.01-162; p = 0.04]). The minimum lactate, a surrogate of persistent hyperlactatemia, was demonstrated to be superior compared with maximum lactate and lactate clearance in determining patient prognosis.
高乳酸血症在心脏移植后很常见。分析了移植后 24 小时内的乳酸测量值与死亡率的关系。回顾了 153 例连续心脏移植患者。包括器官在灌注状态下保存的受体。共有 143 例心脏受体被纳入。所有患者均存在高乳酸血症（>2mmol/l）。尽管非幸存者的最大乳酸和乳酸清除率显著更高（p=0.002，p=0.004），但接收器操作曲线分析和多变量逻辑回归均未显示与 1 年死亡率相关。相比之下，最小乳酸与死亡率显著相关（曲线下面积 0.728 [p<0.001]；优势比 1.28 [95%1.01-162；p=0.04]）。持续高乳酸血症的替代物最小乳酸，在确定患者预后方面，与最大乳酸和乳酸清除率相比表现出优越性。
