• Jeffrey Kim, Andrew Wu, Tristan Grogan, Theodore Wingert, Jennifer Scovotti, Wolf Kratzert, and J Prince Neelankavil.
• Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA. Electronic address: jeffrey.s.kim@kp.org.
• J. Cardiothorac. Vasc. Anesth. 2020 Oct 1; 34 (10): 2641-2647.

ObjectivesTo assess whether lactate levels are associated with clinical outcomes in adult congenital heart disease patients who undergo cardiac surgery.DesignRetrospective study.SettingSingle quaternary academic referral center.ParticipantsAdult congenital heart disease patients (≥18 y old) with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass.InterventionsParticipants were classified into 3 groups according to their peak arterial lactate level within the first 48 hours of surgery.Measurements And Main ResultsIn-hospital 30-day mortality, hospital and intensive care unit length of stay, duration of mechanical ventilation after surgery, acute kidney injury defined by Acute Kidney Injury Network criteria, and intensive care unit and hospital readmission within 30 days of surgery were examined. There was no significant difference among different lactate level groups in acute kidney injury, hospital length of stay, intensive care unit length of stay, hours of mechanical ventilation, need for redo surgery, or rates of hospital or intensive care unit readmission. In multivariable analysis, which included cardiopulmonary bypass time, redo surgery, nonelective case, and the adult congenital heart disease complexity score, lactate levels were not a significant predictor of either acute kidney injury or hospital length of stay.ConclusionsThe appeal of using lactate levels to risk stratify-patients or to develop a model to predict mortality and morbidity has potential merit, but currently there is insufficient evidence to use lactate levels as a predictor of outcomes in adult patients with congenital heart disease undergoing cardiac surgery.Published by Elsevier Inc.

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