• Nana Furushima, Moritoki Egi, Yuriko Nakada, Daisuke Ono, and Junichi Araki.
• Masui. 2014 Aug 1; 63 (8): 846-50.

BackgroundWe conducted a retrospective analysis of the intraoperative lactate level and its association with patients' outcome in adult cardiac surgery patients requiring cardiopulmonary bypass.MethodsThe study was approved by the local institutional ethics committee. We included 68 adult patients who had undergone cardiac surgery with cardiopulmonary bypass. Primary outcome is intensive care free survival days at postoperative 28 days (ICU free survival days at POD 28). Blood lactate levels were measured during the operation, and we calculated the maximum lactate levels 1) during surgery, 2) before commencement of cardiopulmonary bypass (CPB), 3) during CPB, and 4) after weaning from CPB.ResultsThe maximum lactate levels during surgery was significantly associated with ICU free survival days (r = -0.30, P = 0.01). Such an association was dominantly seen in the maximum lactate level after CPB (r = -0.31, P = 0.01) (Table 1). Even after adjusted relevant confounders, the maximum lactate after CPB was independently associated with decreased ICU free survival days at POD 28 (Table 2).ConclusionsIncreased lactate concentrations after weaning from CPB were significantly and independently associated with ICU free survival days at POD 28. This finding may be important to physicians in managing patients undergoing cardiac surgery using CPB.

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