Kardiyak Cerrahide Santral Venöz Laktat Ölçümü Arteryel Laktat Ölçümünün Yerini Tutabilir mi?

Amaç: Doku perfüzyonunun yeterliliği için önemli bilgi veren laktat düzeyleri, genellikle kan gazlarıyla birlikte kan gazı cihazları tarafından ölçülür. Her ne kadar arteriyel kan, laktat ölçümü için “altın standart” olsa da, arteryel ve venöz laktat ölçümlerinin birbirinin yerine kullanılabilmesi, venöz kan gazı değerlendirmesinin tercih edildiği durumlarda, sık kan örneklemesinin neden olabileceği artmış maliyet ve iatrojenik anemiye engel olabilir. Bu çalışmada amacımız; on-pump kardiyak cerrahide arteryel (AL) ve santral venöz laktat (CVL) değerleri arasındaki korelasyon ve uyumu incelemektir. Yöntem: Anestezik yönetim dahilinde, T1: anestezi indüksiyonu sonrası, T2: kros klemp sırasında ve T3: cilt kapatılırken olmak üzere üç aşamada eşzamanlı olarak arteryel ve venöz kan örnekleri olan yetişkin hastalar, bu retrospektif gözlemsel çalışmaya dahil edildi. CVL ve AL konsantrasyonları, T1, T2 ve T3 aşamalarındaki kan gazı analizinden elde edildi. Spearman Rho and Bland-Altman Testleri, AL ve CVL arasındaki sırasıyla korelasyon ve uyumu değerlendirmek için kullanıldı. Bulgular: Toplamda 122 uygun hastadan 366 çift kan örneği elde edildi. 95% güven aralıkları sırasıyla; T1’de -0.07 ve -0.00, T2’de 0.30 ve -0.10 ve T3’de -0.16 ve -0.03’tü. 95% CI ise T1’de 0.86 ve 0.93 (r=0.90 ve p

Does Central Venous Lactate Measurement Replace Arterial Lactate Measurement in Cardiac Surgery?

Objective: Lactate levels, which provide valuable information about the adequacy of tissue perfusion, are usually measured by blood gas analyzers simultaneously with blood gases. Althougharterial blood is the “gold standard” for measurement of lactate, the interchangeable use of arterial and venous lactate measurements can avoid increased costs and iatrogenic anemia resultingfrom frequent blood sampling when evaluation of venous blood gas samples are preferred. In thisstudy; we aimed to examine the correlation and agreement between the arterial lactate (AL) andcentral venous lactate (CVL) values in patients undergoing on-pump cardiac surgery.Method: Adult patients who had both arterial and central venous blood gas sampling simultaneously in three stages (T1: after anesthesia induction, T2: during cross- clamping, T3: during skinclosure) of operation as part of anesthetic management were eligible for inclusion in this retrospective study. CVL and AL concentrations were estimated during blood gas analysis at stages T1,T2 and T3. Spearman Rho and Bland-Altman Tests were used to assess correlation and agreementbetween AL and CVL measurements, respectively.Results: Totally 366 pairs of blood samples were obtained from 122 eligible patients. The 95%limits of agreement were -0.07 to -0.00 at T1; 0.30 to -0.10 at T2 and -0.16 to -0.03 at T3. The95% Cls were detected 0.86 to 0.93 (r=0.90 and p

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