Intraoperative change of lactate level is associated with postoperative outcomes in pediatric cardiac surgery patients: retrospective observational study.
Intraoperative change of lactate level is associated with postoperative outcomes in pediatric cardiac surgery patients: retrospective observational study.
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乳酸水平的术中变化与儿科心脏手术患者的术后结局有关：回顾性观察性研究。
DOI：
10.1186/s12871-015-0007-y
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发表时间：
2015
影响因子：
2.2
通讯作者：
Morimatsu H
中科院分区：
文献类型：
--
作者：
Kanazawa T;Egi M;Shimizu K;Toda Y;Iwasaki T;Morimatsu H
血清乳酸浓度的变化似乎有助于预测各种急性疾病的预后。然而，有关儿科心脏手术患者术中乳酸水平变化的信息很少。我们对459例接受心脏手术的儿童进行了回顾性观察，以确定体外循环(CPB)后乳酸水平的变化与患者预后(ICU住院时间和术后严重不良事件的发生率)之间的关系。我们将体外循环后乳酸水平的变化(LAC⊿)定义为(手术室内的最终乳酸水平测量)-(在体外循环结束时测量的乳酸水平)。采用线性回归模型研究⊿与ICU住院时间的独立相关性。在这项研究队列中，CPB后有1145次乳酸测定。脱机后血清乳酸水平由2.1mmoL/L升至2.5mmoL/L(p <； 0.001)。LAC⊿越高的患者在ICU的住院时间越长(p = 0.017)，SAE的发生率也越高(p = 0.002)。多元线性回归分析显示，更高的LAC⊿与更长的ICU住院时间有显著的独立关联。儿科心脏手术患者体外循环后乳酸水平升高与ICU住院时间延长和术后SAE风险增加有关。应该进行进一步的研究，以确定术中乳酸水平趋势的临床实用性。本文的在线版本(doi：10.1186/s12871-0150007-y)包含补充材料，授权用户可以使用。
A change of serum lactate concentrations appeared to be useful for predicting outcomes in various acute ill settings. However, there is little information on intraoperative change of lactate level in pediatric cardiac surgery patients. We conducted a retrospective observational study of 459 children who received pediatric cardiac surgery to determine the association between change of lactate level after cardiopulmonary bypass (CPB) and patient prognosis (length of ICU stay and incidence of postoperative serious adverse events (SAEs)). We defined change of lactate level after CPB (LAC⊿) as (final lactate level measurement in the operating room) – (lactate level measured at the end of CPB). To study the independent association of LAC⊿ with length of ICU stay, we used linear regression model. There were 1145 lactate measurements after CPB in this study cohort. After weaning from CPB, the serum lactate levels significantly increased from 2.1 mmol/L to 2.5 mmol/L (p < 0.001). Patients with higher LAC⊿ had significantly longer stay in ICU (p = 0.017) and higher incidence of SAEs (p = 0.002). In multivariate linear regression analysis, higher LAC⊿ showed a significant independent association with longer length of ICU stay. Increased lactate level after CPB was associated with the longer duration of ICU stay and increased risk of postoperative SAEs in pediatric cardiac surgery patients. Future studies should be conducted to determine the clinical utility of intraoperative trend of lactate levels. The online version of this article (doi:10.1186/s12871-015-0007-y) contains supplementary material, which is available to authorized users.
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影响因子：
3.4
作者：
Murtuza, Bari;Wall, Douglas;Brawn, William J.
通讯作者：
Brawn, William J.
影响因子：
1.7
作者：
Alves, Rodrigo Leal;Aragao e Silva, Andre Luiz;Pinheiro Modolo, Norma Sueli
通讯作者：
Pinheiro Modolo, Norma Sueli
DOI：
10.1186/cc10497
发表时间：
2011
期刊：
Critical care (London, England)
影响因子：
--
作者：
Nichol A;Bailey M;Egi M;Pettila V;French C;Stachowski E;Reade MC;Cooper DJ;Bellomo R
通讯作者：
Bellomo R
DOI：
10.1016/s0022-5223(97)70018-7
发表时间：
1997-12-01
影响因子：
6
作者：
Duke, T;Butt, W;Karl, TR
通讯作者：
Karl, TR
DOI：
10.1186/cc9217
发表时间：
2010
期刊：
Critical care (London, England)
影响因子：
--
作者：
Ranucci M;Isgrò G;Carlucci C;De La Torre T;Enginoli S;Frigiola A;Surgical and Clinical Outcome REsearch Group
通讯作者：
Surgical and Clinical Outcome REsearch Group