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Tissue hypoperfusion during cardiopulmonary bypass (CPB) affects cardiac surgical outcomes. Lactate, an end product of anaerobic glycolysis from oxygen deficit, is an obtainable marker of tissue hypoxia. The investigators aimed to determine the value of blood lactate level during CPB in adult cardiac surgeries in predicting outcomes.
The investigators retrospectively reviewed the patients underwent cardiac surgeries with CPB from January 2015 to December 2015. The patient's characteristics, pre-operative status, surgical type, and intra-operative lactate levels were collected. The outcomes were in-hospital mortality and complications. Receiver operating characteristics (ROC) curves were used to assess the ability of peak lactate level during CPB to predict in-hospital mortality.
The baseline characteristics, including age, gender, body mass index (BMI), comorbidities, left ventricular ejection fraction (LVEF, %), European system for cardiac operative risk evaluation II (EuroSCORE II), pre-operative hematocrit, and serum creatinine levels were recorded. The surgical type was classified as coronary artery bypass grafting (CABG), valve surgery, combined surgery including CABG and valve surgery, great vessel surgery including aortic dissection, and other surgeries. The priority of surgery was classified as elective, urgent, and emergent. The intra-operative variables included CPB time, aortic cross-clamp time, initial lactate level at the beginning of the operation, and the peak lactate level during CPB.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| lactate during CPB | check lactate levels routinely during cardiac operations with cardiopulmonary bypass, choose the peak lactate data |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| serum lactate | Diagnostic Test | check lactate levels during cardiopulmonary bypass in adult cardiac operations |
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| Measure | Description | Time Frame |
|---|---|---|
| in-hospital mortality | peak lactate level during cardiopulmonary bypass predicts in-hospital mortality | From date of inclusion until date of death from any cause during hospitalization, assessed up to one year |
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Inclusion Criteria:
Exclusion Criteria:
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adults patients underwent cardiac surgeries with cardiopulmonary bypass from January 2015 to December 2015
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| Name | Affiliation | Role |
|---|---|---|
| Yi-tso Cheng, MD | Hualien Tzu Chi General Hospital | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11156124 | Result | Demers P, Elkouri S, Martineau R, Couturier A, Cartier R. Outcome with high blood lactate levels during cardiopulmonary bypass in adult cardiac operation. Ann Thorac Surg. 2000 Dec;70(6):2082-6. doi: 10.1016/s0003-4975(00)02160-3. | |
| 22813486 | Result | O'Connor E, Fraser JF. The interpretation of perioperative lactate abnormalities in patients undergoing cardiac surgery. Anaesth Intensive Care. 2012 Jul;40(4):598-603. doi: 10.1177/0310057X1204000404. |
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The individual participant data (IPD) will be available on request.
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