The relationship of hyperlactatemia following paediatric open heart surgery with mortality, morbidity and risk factors
Küçük Resim Yok
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, pediatrik açık kalp cerrahisi uygulanan hastalarda hiperlaktatemi sıklığının olası risk faktörleri, postoperatif morbidite ve mortalite ile ilişkisi araştırıldı. Materyal ve Metot: Bu çalışma Ocak 2008 ve Temmuz 2008 arasında kardiyovasküler cerrahi kliniğinde hipotermik kardiyopulmoner baypas ile açık kalp ameliyatı geçirmiş 45 ardışık pediatrik hastayı kapsadı. Her hastadan laktat analizi için preoperatif, intraoperatif ve postoperatif 1. ve 12. saat olmak üzere dört kan örneği alındı. Hastalar laktat düzeylerine göre yüksek laktat grubu (ortalama laktat düzeyi ?3 mmol/L) ve normal laktat grubu (ortalama laktat düzeyi <3 mmol/L) olarak iki gruba ayrıldı. Hiperlaktatemi sıklığı, ilişkili risk faktörleri ve morbidite ve mortalite ile ilişki istatistiksel olarak analiz edildi. Bulgular: 45 olgunun, 33’ü (%73.3) normal laktat (NL) grubuna ve 12’si (%26.7) yüksek laktat (HL) grubuna dahil edildi. HL grubunda laktat düzeyleri ile mortalite arasında sınırda bir ilişki bulundu (p=0.052). Vücut yüzey alanı, yaş, düşük kalp debisi sendromu, intraoperatif ve postoperatif inotropik destek gereksinimi, mekanik ventilasyon süresi mortalite ile ilişkili risk faktörleri olarak belirlendi (p<0.05). Düşük kalp debisi sendromu, idrar çıkışı ve metabolik asidoz hiperlaktatemi ile ilişkili risk faktörleri olarak belirlendi (p<0.05). Sonuç: Yoğun bakım ünitesinde takip edilen hastalarda, laktat konsantrasyonu hastalık şiddeti için iyi bir göstergedir. Kan laktat düzeyleri rutin takipte kullanılabilecek bir parametre gibi görünmektedir.
Objective: In this present study, the association of hyperlactatemia frequency with probable risk factors, postoperative morbidity and mortality were investigated in patients undergoing paediatric open heart surgery. Materials and Methods: The present study included 45 consecutive paediatric patients who had undergone open heart surgery with hypothermic cardiopulmonary bypass in the cardiovascular surgery clinic between January 2008 and July 2008. Four blood samples for lactate analysis were collected from each of the patients preoperatively, intraoperatively and at 1 and 12 hours post- operatively. The patients were divided into two groups according to blood lactate levels as the high lactate group (mean lactate level&#8805; 3 mmol/L) and the normal lactate group (mean lactate level <3 mmol/L). Hyperlactatemia frequency, associated risk factors, and the relationship with morbidity and mortality were statistically analysed. Results: Of 45 cases, 33 (73.3%) were included in the normal lactate (NL) group, and 12 (26.7%) were included in the high lactate (HL) group. A borderline association was found between lactate levels and mortality in the HL group (p=0.052). Body surface area, age, low cardiac output syndrome, intraoperative and postoperative inotropic support requirement, duration of mechanical ventilation were determined as risk factors associated with mortality (p<0.05), and low cardiac output syndrome, urine output and metabolic acidosis were determined as risk factors associated with hyperlactatemia (p<0.05). Conclusion: In patients followed up in the intensive care unit, lactate concentration is a good indicator for disease severity. Blood lactate levels seems to be a parameter that can be used in routine follow-up.
Objective: In this present study, the association of hyperlactatemia frequency with probable risk factors, postoperative morbidity and mortality were investigated in patients undergoing paediatric open heart surgery. Materials and Methods: The present study included 45 consecutive paediatric patients who had undergone open heart surgery with hypothermic cardiopulmonary bypass in the cardiovascular surgery clinic between January 2008 and July 2008. Four blood samples for lactate analysis were collected from each of the patients preoperatively, intraoperatively and at 1 and 12 hours post- operatively. The patients were divided into two groups according to blood lactate levels as the high lactate group (mean lactate level&#8805; 3 mmol/L) and the normal lactate group (mean lactate level <3 mmol/L). Hyperlactatemia frequency, associated risk factors, and the relationship with morbidity and mortality were statistically analysed. Results: Of 45 cases, 33 (73.3%) were included in the normal lactate (NL) group, and 12 (26.7%) were included in the high lactate (HL) group. A borderline association was found between lactate levels and mortality in the HL group (p=0.052). Body surface area, age, low cardiac output syndrome, intraoperative and postoperative inotropic support requirement, duration of mechanical ventilation were determined as risk factors associated with mortality (p<0.05), and low cardiac output syndrome, urine output and metabolic acidosis were determined as risk factors associated with hyperlactatemia (p<0.05). Conclusion: In patients followed up in the intensive care unit, lactate concentration is a good indicator for disease severity. Blood lactate levels seems to be a parameter that can be used in routine follow-up.
Açıklama
Anahtar Kelimeler
Pediatrik Açık Kalp Cerrahisi, Hiperlaktatemi, Laktat
Kaynak
Erciyes Tıp Dergisi
WoS Q Değeri
N/A
Scopus Q Değeri
N/A
Cilt
36
Sayı
1
