ArticleJournal of cardiothoracic surgery2016
Outcomes of post-cardiac surgery patients with persistent hyperlactatemia in the intensive care unit: a matched cohort study.
Article in Journal of cardiothoracic surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed.
- Deep Hypothermic Circulatory Arrest vs. Antegrade Cerebral Perfusion in Cerebral Protection during the Surgical Treatment of Chronic Dissection of the Ascending and Arch Aorta.The journal of extra-corporeal technology · 2017Trial
- Perioperative Blood Biomarkers of Infectious and Non-Infectious Postoperative Pulmonary Complications: A Narrative Review.Journal of clinical medicine · 2026Review
- Development and validation of a predictive model for postoperative hepatic dysfunction in Stanford type A aortic dissection.Scientific reports · 2025Article
- Acute Ischemic and Hemorrhagic Cerebrovascular Strokes After Cardiac Surgery: Incidence, Predictors, and Outcomes.Critical care research and practice · 2025Article
- A Rapid Increase in Serum Lactate Levels after Cardiovascular Surgery Is Associated with Postoperative Serious Adverse Events: A Single Center Retrospective Study.Diagnostics (Basel, Switzerland) · 2024Article
- Association of Postoperative Serum Lactate Levels with Acute Kidney Injury in Mexican Patients Undergoing Cardiac Surgery.Clinics and practice · 2024Article
- Factors associated with increased lactate levels in cardiac surgeries: scoping review.Revista brasileira de enfermagem · 2024Article
- Association between lactic acidosis and multiple organ dysfunction syndrome after cardiopulmonary bypass.PeerJ · 2024Article
- Model-driven survival prediction after congenital heart surgery.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Predictive role of arterial lactate in acute kidney injury associated with off-pump coronary artery bypass grafting.Frontiers in surgery · 2023Article
- Predictors and clinical outcomes of post-coronary artery bypass grafting cerebrovascular strokes.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2022Article
- The effect of cardiopulmonary bypass on blood thiamine concentration and its association with post-operative lactate concentration.Journal of cardiothoracic surgery · 2022Observational
- Severe hyperlactatemia in unselected surgical patients: retrospective analysis of prognostic outcome factors.BMC surgery · 2022Article
- Hyperlactatemia as a prognostic indicator for contemporary left ventricular assist device implantation.General thoracic and cardiovascular surgery · 2022Article
- Impact of Single versus Double Clamp Technique on Blood Lactate Levels and Postoperative Complications in Coronary Artery Bypass Surgery.Brazilian journal of cardiovascular surgery · 2022Article
- Association Between Hypernatremia and Delirium After Cardiac Surgery: A Nested Case-Control Study.Frontiers in cardiovascular medicine · 2022Article
- Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery.Frontiers in medicine · 2021Article
- Resistance Index of the Superior Mesenteric Artery: Correlation With Lactate Concentration and Kinetics Prediction After Cardiac Surgery.Frontiers in medicine · 2021Article
- Midterm cerebral outcomes of Stanford type A aortic dissection in patients who underwent novel triple-branched stent graft implantation combined with intraoperative monitoring of regional cerebral oxygen saturation.Journal of cardiac surgery · 2019Article
- Serum Lactate As Reliable Biomarker of Acute Kidney Injury in Low-risk Cardiac Surgery Patients.Journal of medical biochemistry · 2019Article
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4 authors.
Funding
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Abstract
backgroundHigher morbidity and mortality rates are seen amongst patients presenting with hyperlactatemia in the postoperative period. The purpose of this study was to determine the relationship between persistent elevations in lactate and poor ICU outcome in post-cardiac surgery patients.
methodsThis was a retrospective matched cohort analysis of cardiac surgery patients undergoing bypass and/or valve surgery in a university hospital centre. Selection criteria were: cardiac bypass and/or valve surgery; admission to the ICU for > 24 h postoperatively; and peak lactate ≥ 3.0 mmol/L. Hyperlactatemic patients were matched to 2 normolactatemic patients. Multivariable conditional logistic regression was used to determine predictors of hyperlactatemia and mortality.
resultsFour hundred sixty-nine post-cardiac surgery patients were admitted to the ICU for > 24 h. 144 of these patients had an arterial blood lactate ≥ 3.0 mmol/L. Amongst the mortalities, 78.9 % presented with hyperlactatemia. Independent risk factors predictive of a lactate ≥ 3.0 mmol/L were preoperative IABP insertion (RR 2.8, CI 1.1-7.2) and postoperative acute kidney injury (RR 3.2, CI 2.1-5.4). Patients whose lactate concentrations continued to increase >30 h postoperatively were more likely to die (RR 8.44 CI 2.50-28.53).
conclusionsThe persistence of hyperlactatemia is a more important determinant of postoperative outcome than the absolute value of the peak lactate concentration. A simple postoperative lactate washout does not sufficiently explain this lactate accumulation. Mortality is proposed to be secondary to a state of ongoing hypoperfusion.
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