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


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Authors: L.V. Chegrina, M.M. Rybka

Company:
A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

Link: Clinical Physiology of Blood Circulaiton. 2015; (): -

Quote as: Chegrina L.V., Rybka M.M.. Interrelation of increase postoperative level troponin T and a lactate with development of complications in the patients operated with application of cardiopulmonary bypass. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2015; 1: 42-48 (in Russ.)

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Abstract

Objective – to determine the relationship of the serum concentration of troponin and lactate as a marker of intraoperative myocardial injury during cardiac surgery with cardiopulmonary bypass.

Material and methods. In total, the study included 50 patients with acquired heart valvular who were operated under cardiopulmonary bypass (CB) with aortic cross-clamping. All patients have been carried out routine monitoring, accepted in the category of operations. The estimation of all the main laboratory parameters, determination of serum lactate, as well as quantification of troponin T were conducted.

Results. The patients were divided into three groups in terms of troponin T and the lactate at the end of perfusion. Where in split point were determined by ROC-made and ready for troponin 1,11 ng/ml, and 5,4 mmol/l of lactate. We have found that increasing levels of troponin T postperfusion period significantly increases the risk of postoperative morbidity as well as prolongs finding patients on mechanical ventilation. While comparing the same group with high levels of troponin, but differing in lactate concentration after CB, no differences were detected, i.e. high levels of blood lactate does not define a long-term stay of the patient in the intensive care unit.

Conclusion. Thus, an increased the level of troponin T has a greater prognostic value than the increase in serum lactate. The increase of troponin more than 10 times compared with the normal value is associated with a significant increase in the risk of complications in cardiac surgery patients in the postoperative period. Promotes the same intraoperative myocardial injury and accordingly increases the level of troponin T in blood a long period of cardiopulmonary bypass and aortic cross-clamping, as well as initially plight of the patient.

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