Nurgül YURTSEVEN, Şahin TILMAZ, Sevim CANİK, Abdullah Kemal TUYGUN, Yasemin YAVUZ

Hyperlactatemia after coronary artery bypass surgery: risk factors and effect on mortality

Amaç: Bu çalışmada, koroner arter bypass greftleme (KABG) ameliyatı sonrası gelişen hiperlaktatemi ile ilişkili risk faktörlerin belirlendi ve hiperlaktateminin mortalite ve morbidite üzerindeki etkileri analiz edildi.Çalışma planı: Elektif KABG ameliyatı geçiren ardışık 482 hasta ileriye dönük olarak çalışmaya alındı ve iki gruba ayrıldı: Grup 1, yoğun bakım ünitesi (YBÜ)'ndeki ilk ölçümde kan laktat düzeyi yüksek olan 260 hasta (>3.5 mmol/l); grup 2, kan laktat düzeyi normal olan 222 hasta (140 mg/dL), KPB süresince hemodinamik instabilite varlığı ve vasopressör gereksinimi, üç saatten daha uzun süre inotropik ajan kullanımı, YBÜ'de beş farklı zaman noktasında değerlendirilen ısı ve laktat değişimleri ölçüldü. Ameliyat sonrası nörolojik, infeksiyöz ve renal komplikasyonlar, mekanik ventilasyon ve YBÜ'de k alış süreleri kaydedildi.Bulgular: Ameliyat sırasında uzun KPB ve KK süreleriyle hemodinamik instabilitesi olan hastaların kan laktat düzeylerinin anlamlı ölçüde daha yüksek olduğu saptandı. Ameliyat sonrasında glukoz düzeyleri yüksek ve inotropik ajan gereksinimi fazla olan hastalarda, laktat düzeyleri de daha yüksek idi. Grup 1'deki hastaların ekstübasyon ve YBÜ'de kalış süreleri daha uzundu. Kan laktat düzeyleri ile mortalite ve morbidite arasında anlamlı bir bağıntı vardı (p

Koroner arter bypass cerrahisi sonrası hiperlaktatemi: Risk faktörleri ve mortalite ilişkisi

Background: This study aims to determine the risk factors for hyperlactatemia developing after coronary artery bypass grafting (CABG) surgery and to analyze its effect on mortality and the morbidity.Methods: Four-hundred and eighty-two consecutive patients who had undergone elective CABG were prospectively included in the study and divided into two groups: group 1 (n=260), patients who had high blood lactate levels in the first measurement (>3.5 mmol/l) in the intensive care unit (ICU); group 2 (n=222), patients who had normal blood lactate levels (140 mg/dL), the presence of hemodynamic instability and requirement for vasopressors during CPB, inotropic agent administration for more than three hours and the temperature and lactate changes at five different time points during ICU stay were measured. Postoperative neurologic, infectious and renal complications and the durations of ICU stay and mechanical ventilation were recorded.Results: The blood lactate levels were found significantly higher in patients with longer CPB and CC durations and peroperative hemodynamic instability. Postoperatively, the patients who had high glucose levels and high inotropic agent needs also had higher lactate levels. The patients in group 1 had longer extubation times and ICU stays. There was a significant correlation between blood lactate levels and mortality and morbidity (p

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