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


Hyperlactatemia after coronary bypass grafting, performed with cardiopulmonary bypass

Authors: D.Sh. Samuilova, G.V. Lobacheva, I.V. Samorodskaya, U.L. Borovkova, I.I. Skopin, L.A. Boсkeria

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery of Russian Academy of Medical Sciences

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Link: Clinical Physiology of Blood Circulaiton. 2014; (): -

Quote as: Samuilova D.Sh., Lobacheva G.V., Samorodskaya I.V., at al. Hyperlactatemia after coronary bypass grafting, performed with cardiopulmonary bypass. Klinicheskaya Fiziologiya Krovoobrashcheniya. 2014; 1: 44–52.

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Abstract

Objective. The aim of the study was to define frequency and reasons of hyperlactatemia occurs in patients underwent coronary bypass grafting (CABG).

Material and methods. The retrospective study included 329 adult patients who underwent CABG between January and December 2011. Results. Hyperlactatemia was observed in 45.8% patients during or immediately after the surgery. In the postoperative period, we observed variable changes in lactate levels (lactate levels remained unchanged, increased or decreased). Low hematocrit (<24%), cardiopulmonary bypass longer than 120 min, hyperglycemia (>11 mmol/l) or their combination were frequently associated with patients who developed hyperlactatemia. Patients with hyperlactatemia were more likely to be exposed to a combination of pre- and intraoperative risk factors for metabolic disorders.

Conclusion. The obtained results suggest that hyperlactatemia in the studied patients is mostly caused by a combination of pre- and intraoperative risk factors. Stimulation of aerobic glycolysis also plays a role in lactate formation. Aerobic glycolysis results from hyperglycemia, which develops not only in response to the release of endogenous stress hormones, but also in response to adrenaline injection.


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