Hadipourzadeh Fatemehshima, Rastravan Roxana, Totonchi Ziae, Heydarpur Evaz, Faritous Zahra
Rajaie Cardiovascular Medical and Research Institute, Iran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2024;16(2):129-134. doi: 10.34172/jcvtr.33051. Epub 2024 Jun 25.
Postoperative Acute renal failure related to cardiac surgery is a common complication due to cardiac surgery and is estimated to influence up to 30% of patients. Serum lactate is a famous biomarker of tissue ischemia and is regularly checked during surgery.
In this retrospective observational research, the records of 395 patients undergoing CABG were examined. Patients were classified into 4 groups based on the difference between the maximum lactate level measured during surgery and its baseline level. Also creatinine and urea levels, blood sugar, hemoglobin, and hematocrit pre, postoperative were recorded. The intraoperative and postoperative use of inotropes and the durations of surgery, cardiopulmonary bypass pump, and aortic cross-clamping were also recorded.
According to the results, pre, post and 24-hour postoperative blood urea nitrogen were not significantly related to intraoperative lactate changes. Also, pre and 24-hour postoperative creatinine had no significant relationship with intraoperative lactate changes, while postoperative creatinine was significantly associated with intraoperative lactate changes ( value=0.05). The duration of cardiopulmonary bypass ( value=0.02), intraoperative inotrope infusion ( value=0.03), inotrope infusion during the first six hours in ICU ( value=0.049), and receiving packed cell ( value=0.006) and receiving platelets during surgery ( value=0.04) were significantly related to intraoperative lactate changes. Furthermore, no significant relationship was observed between the duration of hospitalization in the ICU and the hospital and intraoperative lactate changes.
According to the results, blood lactate level is an unreliable marker for predicting renal dysfunction postoperative.
与心脏手术相关的术后急性肾衰竭是心脏手术常见的并发症，估计影响高达30%的患者。血清乳酸是组织缺血的著名生物标志物，在手术期间经常进行检测。
在这项回顾性观察研究中，检查了395例行冠状动脉旁路移植术（CABG）患者的记录。根据手术期间测得的最大乳酸水平与其基线水平之间的差异，将患者分为4组。还记录了术前、术后的肌酐和尿素水平、血糖、血红蛋白和血细胞比容。还记录了术中及术后使用的血管活性药物以及手术时间、体外循环泵时间和主动脉阻断时间。
根据结果，术前、术后及术后24小时的血尿素氮与术中乳酸变化无显著相关性。此外，术前及术后24小时的肌酐与术中乳酸变化无显著关系，而术后肌酐与术中乳酸变化显著相关（P值=0.05）。体外循环时间（P值=0.02）、术中血管活性药物输注（P值=0.03）、重症监护病房（ICU）前6小时的血管活性药物输注（P值=0.049）、术中接受浓缩红细胞（P值=0.006）和接受血小板（P值=0.04）与术中乳酸变化显著相关。此外，ICU住院时间、住院时间与术中乳酸变化之间未观察到显著关系。
根据结果，血乳酸水平是预测术后肾功能障碍的不可靠标志物。
