Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Гематологические и биохимические предикторы течения послеоперационного периода у кардиохирургических больных (ретроспективное исследование)

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Link: Clinical Physiology of Blood Circulaiton. 2012; (): -

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Abstract

Objective. The aim of the study was to determine the significance of certain laboratory values (and time of blood sampling for evaluation of these rates) in prediction of mortality in cardiosurgical patients who had undergone cardiac surgery under cardiopulmonary bypass (CPB). Material and methods. The retrospective study included 189 adult patients who underwent cardiac surgeries under CPB in 2011. Results. Multivariate analysis showed that hematocrit value of less than 28% at the end of surgery, urinary level on the third day of more than 15 mmol/l, lymphocyte count on the third and fifth days of less than 10% were clinically and statistically significant predictors of mortality. Increased lactate level of more than 3.0 mmol/l and 10 mmol/l at the end and in 5 hours after surgery, respectively, was associated with significant mortality risk, but this value cant provide satisfactory quality of unfavorable outcome prediction and its significance should be considered individually for each patient. Conclusion. Increased lactate level as a predictor of inadequate tissue perfusion since only lactate level cant provide the assessment of disease severity and prognosis.

References

Jyarala A., Weiss R. E., Jeffries R. A., Kay G.L. Effect of mild renal dysf unction (s-crea 1/2-2/2 mg/dl) on presentation characteristics and short- and long-term outcomes of onpump cardiac surgery patients // Interact. CardioVasc. Thorac. Surg. 2010. Vol. 10. P. 777-782.
Karkouti K., Beattie W.S., Wijeysundera D.N. et al. Hemodilution during cardiopulmonary bypass is an independent risk factor for acute renal failure in adult cardiac surgery // J. Thorac. Cardiovasc. Surg. 2005. Vol. 129. P. 391-400.
Lassnigg A., Schmid E.R., Hiesmayr M. et al. Impact of minimal increases in serum creatinine on outcome in patients after cardiothoracic surgery: do we have to revise current definitions of acute renal failure? // Crit. Care Med. 2008. Vol. 36. P. 1129-1137.
Loor G., Sabik J.F., Rajeswaren J. et al.Nadir Hematocrit during cardiopulmonary bypass: End-organ dysfunction and mortality // J. Thorac. Cardiovasc. Surg. 2012. Vol. 144, № 3. P. 654-662.
Miceli A., Bruno V.D., Capoun R. et al. Occult renal dysfunction: a mortality and morbidity risk factor in coronary artery bypass grafting surgery // J. Thorac. Cardiovasc. Surg. 2011. Vol. 141. P. 771-776.
Nicks B. A. et al. Emergent Management of Lactic Acidosis // emedicine. medscape. com
O'Connor E., Fraser J.F. The interpretation of perioperative lactate abnormalities in patients undergoing cardiac surgery // Anaesth. Intens. Care. 2012. Vol. 40, №4. P. 598-603
Provenche` re S., Plantefe`ve G., Hufnagel G. et al. Renal dysfunction after cardiac surgery with normothermic cardiopulmonary bypass: Incedence, risk factors, and effect on clinical outcome // Anesthesia & Analgesia. 2003. Vol. 96, № 5. P. 1258-1264.
Ranucci M. Perioperative failure: hypoperfusion during cardiopulmonary bypass? // Semin. Cardiothorac. Vasc. Anesth. 2007. Vol. 11, № 4. P. 265-268.
Ranucci M., Conti D., Castelvecchio S. et al. Hematocrit on cardiopulmonary bypass and outcome after coronary surgery in nontransfused patients // Ann. Thorac. Surg. 2010. Vol. 89. P. 11-17.
Ranucci M., De Toffol B., Isgro G. et al. Hyperlаctatemia during cardiopulmonary bypass: determinants and impact on postoperative outcome // Crit. Care. 2006. Vol. 10, № 6. R. 167.
Shinde S.B., Golam K.K., Kumar P., Patil N.D. Blood lactate levels during cardiopulmonary bypass for valvular heart surgery // Ann. Card. Anaesth. 2005. Vol. 8, № 1. P. 39-44.
Svenmarker S., Hдggmark S., Ostman M. What is a normal lactate level during cardiopulmonary bypass? // Scand. Cardiovasc. J. 2006. Vol. 40, № 5. P. 305-311.
Tolpin D.A., Collard Ch.D., Vei-Vei Lee et al. Subclinical changes in serum creatinine and mortality after coronary artery bypass grafting // J. Thorac. Cardiovasc. Surg. 2012. Vol. 143. P. 682-688.
Vermeer H., Teerenstra S., de Sйvaux R.G. et al. The effect of hemodilution during normothermic cardiac surgery on renal physiology and function: a review // Perfusion. 2008. Vol. 23, № 6. P. 329-338.
Von Heymann C., Sander M., Foer A. et al. The impact of an hematocrit of 20% during normothermic cardiopulmonary bypass for elective lov risk coronary artery bypass graft surgery on oxygen delivery and clinical outcome - a randomized controlled study [ISRCT N35655335] // Crit. Care. 2006. Vol. 10, № 2. R. 58.

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