Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery.
Intraoperative use of cell saver devices decreases the rate of hyperlactatemia in patients undergoing cardiac surgery.
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DOI：
10.1016/j.heliyon.2023.e15999
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发表时间：
2023-05
期刊：
影响因子：
4
通讯作者：
Zhang, Bing
中科院分区：
文献类型：
--
作者：
Zhou, Yenong;Yang, Chen;Jin, Zhenxiao;Zhang, Bing
本研究旨在阐明术中细胞保存器（CS）对心脏手术患者高乳酸血症的影响。进行了CS的亚分析，这是一项接受心脏手术的患者的历史对照试验。这是一项回顾性单中心非盲法研究。我们回顾性检查了CS组（n = 78）患者的高乳酸血症发生率，这些患者被纳入前瞻性试验并接受了瓣膜手术，在手术过程中使用了CS。对照组为2021年2月前行瓣膜手术的患者79例。(1)体外循环术前、(2)体外循环中、(3)体外循环后立即、(4)ICU入院时、(5)术后至24小时每4小时采集一次动脉血。CS组患者的高乳酸血症发生率较低（32.1% vs. 57.0%, P = 0.001）。对照组在CPB、CPB后及ICU入院时血乳酸浓度均高于CS组，且持续至术后20 h。多变量分析显示，在本研究中，术中使用CS有望成为预防高乳酸血症的保护因素（OR = 0.31, 95% CI 0.15-0.63, P = 0.001）。术中使用CS装置可降低高乳酸血症的发生率。这种装置的使用是否对限制心脏术后患者的高乳酸血症有价值，需要在更大的前瞻性研究中进一步评估。
This study was aimed to elucidate the effect of the intraoperative cell saver (CS) on hyperlactatemia of patients who underwent cardiac surgery. A sub-analysis of the CS was performed, which is a historial control trial of patients undergoing cardiac surgery. This was a retrospective single-center and not blinded study. We examined the occurrence of hyperlactatemia retrospectively in patients of CS group (n = 78) who were included in prospective trial and received valvular surgery, where CS was used during the procedure. Patients subjected to valvular surgery before February 2021 were adopted in control group (n = 79). Arterial blood was sampled (1) before cardiopulmonary bypass, (2) during bypass (3) immediately after bypass, (4) on ICU admission and (5) every 4 h up to 24 h postoperatively. A lower incidence of hyperlactatemia (32.1% vs. 57.0%; P = 0.001) was observed in patients from the CS group. Furthermore, the blood lactate concentration was higher in control group than in CS group during CPB, post CPB, on ICU admission and lasted until 20 h after the operation. Multivariable analysis revealed that intraoperative use of CS was expected to be a protective factor against hyperlactatemia in this study (OR = 0.31, 95% CI 0.15–0.63, P = 0.001). Intraoperative use of a CS device was associated with a lower incidence of hyperlactatemia. Whether such device use is valuable to limiting hyperlactatemia in cardiac patients after surgery requires further evaluation in larger prospective studies.
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影响因子：
5.7
作者：
Delaney, Meghan;Stark, Paul C.;Sloan, Steven R.
通讯作者：
Sloan, Steven R.
DOI：
10.1186/s13054-014-0606-x
发表时间：
2014-11-20
期刊：
Critical care (London, England)
影响因子：
--
作者：
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影响因子：
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Rabus MB
影响因子：
1.3
作者：
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