2022/ China(1515 Zhan YF, Shi Q, Pan YC, Zheng BS, Ge YP, Luo TG, et al. Sufentanil: a risk factor for lactic acidosis in patients after heart valve surgery. J Cardiothorac Surg. 2022;17(1):233. https://doi.org/10.1186/s13019-022-01986-5 https://doi.org/10.1186/s13019-022-01986...
) |
Heart valve surgery/ 140 min |
Hypoperfusion, intraoperative sufentanil infusion rate, use of epinephrine |
Inadequate intraoperative sufentanil infusion rate is an independent risk factor for acidosis. |
2022/ Morocco(1616 Seghrouchni A, Atmani N, Moutakiallah Y, Belmekki A, Bekkali YE, Houssa MA. Does severe hyperlactatemia during cardiopulmonary bypass predict a worse outcome?. Ann Med Surg. 2021;73:103198. https://doi.org/10.1016/j.amsu.2021.103198 https://doi.org/10.1016/j.amsu.2021.1031...
) |
Valvular surgery, coronary artery bypass grafting, combined procedure, adult congenital anomalies and aortic surgery/ 120 min |
Hypoperfusion of body tissues and hypoxia cellular, duration of CPB, severe hemodilution |
Blood lactate levels above 5 mmol/L at the end of CPB are associated with worse outcomes. |
2022/ Turkey(1717 Özmen R, Bozguney M, Tekin AI, Eroglu T, Tuncay A. Impact of Single versus Double Clamp Technique on Blood Lactate Levels and Postoperative Complications in Coronary Artery Bypass Surgery. Braz J Cardiovasc Surg. 2022;37(1)55-64. https://doi.org/10.21470/1678-9741-2020-0025 https://doi.org/10.21470/1678-9741-2020-...
) |
Myocardial revascularization/ Time not reported |
Kidney injury, ischemic stroke, hyperglycemia, and blood transfusion |
Longer CPB time was associated with higher lactate levels and increased mortality. |
2020/ Spain(1818 Camacho CG, Paz AJ, Franco CL, Hervás MJ, Otero AM. Continuous ultrafiltration during extracorporeal circulation and its effect on lactatemia: a randomized controlled trial. PLoS One. 2020;15(11). https://doi.org/10.1371/journal.pone.0242411 https://doi.org/10.1371/journal.pone.024...
) |
Valve, coronary and aortic replacement surgeries/ 102 min |
Hemodilution and CPB time |
Reduction in lactatemia resulted in a decrease in morbidity and mortality in the intensive care unit. |
2020/ Japan(1919 Ezaka M, Tsukamoto J, Matsuo K, Kin N, Yamaoka K. Hyperlactatemia of dialysis-dependent patients after cardiac surgery impacts on in-hospital mortality: a two-center retrospective study. JA Clin Rep. 2020;6(1):47. https://doi.org/10.1186/s40981-020-00348-1 https://doi.org/10.1186/s40981-020-00348...
) |
Valve surgeries, CABG, aortic surgeries/Time not reported |
Age, preoperative history of HF, surgery time, CPB time, aortic clamping, and use of adrenaline |
Early onset of a maximum arterial lactate concentration greater than 4.5 mmol/L was significantly associated with in-hospital mortality. |
2019/ Poland(2020 Duchnowski P, Hryniewiecki T, Kuśmierczyk M, Szymański P. The usefulness of perioperative lactate blood levels in patients undergoing heart valve surgery. Kardiochir Torakochirurgia Pol. 2019;16(3):114-7. https://doi.org/10.5114/kitp.2019.88599 https://doi.org/10.5114/kitp.2019.88599...
) |
Heart valve surgery/ 122 min |
Tissue hypoperfusion |
The blood lactate level measured one day after the operation was an independent predictor of death at a 30-day follow-up. |
2018/ Germany(2121 Piot J, Hébrard A, Durand M, Payen JF, Albaladejo P. An elevated respiratory quotient predicts complications after cardiac surgery under extracorporeal circulation: an observational pilot study. J Clin Monit Comput. 2019;33(1):145-53. https://link.springer.com/article/10.1007/s10877-018-0137-0 https://link.springer.com/article/10.100...
) |
Unspecified type of surgery/ 129 min |
Tissue hypoxia, drug therapy, hypothermia |
Excess base severely reduced on ICU admission is superior to lactate levels for predicting ICU mortality. |
2018/ Germany(2222 Zante B, Reichenspurner H, Kubik M, Kluge S, Schefold JC, Pfortmueller CA. Base excess is superior to lactate-levels in prediction of ICU mortality after cardiac surgery. PLoS One. 2018;13(10):e0205309. https://doi.org/10.1371/journal.pone.0205309 https://doi.org/10.1371/journal.pone.020...
) |
Type of surgery not mentioned/5 to 10 min |
CPB time |
In patients who received CPB for two hours or more, venous lactate and partial pressure of carbon dioxide in the blood were higher than baseline values. |
2017/ Saudi Arabia(2323 Nazer RI, Alburikan KA. Metformin is not associated with lactic acidosis in patients with diabetes undergoing coronary artery bypass graft surgery: a case control study. BMC Pharmacol Toxicol. 2017;38(18). https://doi.org/10.1186/s40360-017-0145-6 https://doi.org/10.1186/s40360-017-0145-...
) |
Myocardial revascularization / 100 min |
Tissue anoxia caused by increased vasopressor support after surgery |
Elevated lactic acid levels appear to be directly related to tissue anoxia caused by increased vasopressor support after surgery. |
2017/ United Kingdom(2424 Yusuff HO, Zochios V. Lactic Acidosis and Mitral Valve Surgery: defining the relationship. J Cardiothorac Vasc Anesth. 2018;32(2):644-5. https://doi.org/10.1053/j.jvca.2017.09.033 https://doi.org/10.1053/j.jvca.2017.09.0...
) |
Mitral valve surgery/ Time not reported |
CPB times, epinephrine use, preoperative atrial fibrillation, and preoperative heart failure |
A high level of hyperlactatemia (7 mmol/L) was associated with mortality, but the majority of those who died did not have high levels upon admission to the ICU. |
2016/ Canada(2525 Mak NT, Igbal S, Varennes B, Khwaja K. Outcomes of post-cardiac surgery patients with persistent hyperlactatemia in the intensive care unit: a matched cohort study. J Cardiothorac Surg. 2016;11:33. https://doi.org/10.1186/s13019-016-0411-5 https://doi.org/10.1186/s13019-016-0411-...
) |
Myocardial revascularization and/or valve surgery/ 130 min |
Tissue hypoperfusion |
Mortality is proposed to be secondary to a state of ongoing hypoperfusion. |
2016/ United States(2626 Andersen LW, Holmberg MJ, Berg KM, Chase M, Cocchi MN, et al. Thiamine as an adjunctive therapy in cardiac surgery: a randomized, double-blind, placebo-controlled, phase II trial. Crit Care. 2016:14;20:92. https://doi.org/10.1186/s13054-016-1245-1 https://doi.org/10.1186/s13054-016-1245-...
) |
Myocardial revascularization and valve surgery/Time not reported |
Low ejection fraction, age, reoperation, diabetes, hypertension |
No difference was found in the postoperative period in relation to lactate levels and its association with mortality. |
2015/ Saudi Arabia(2727 Soliman R, Fouad E, Belghith M, Abdelmageed T. Conventional hemofiltration during cardiopulmonary bypass increases the serum lactate level in adult cardiac surgery. Ann Card Anaesth. 2016;19(1):45-51. https://doi.org/10.4103/0971-9784.173019 https://doi.org/10.4103/0971-9784.173019...
) |
Not reported in study |
Hemofiltration during CPB |
Hemofiltration during CPB leads to hemoconcentration, increased serum lactate and inotropic support. |
2015/ China(2828 Zhang Z, Ni H. Normalized lactate load is associated with development of acute kidney injury in patients who underwent cardiopulmonary bypass surgery. PLoS One. 2015;10(3). https://doi.org/10.1371/journal.pone.0120466 https://doi.org/10.1371/journal.pone.012...
) |
Lung bypass surgery/ 83 min |
Administration of lactated Ringer’s solution, distributive shock, type B hyperlactatemia |
There was no direct causal relationship between lactate index and mortality. |
2015/ Netherlands(2929 Ottens TH, Nijsten MW, Hofland J, Dieleman JM, Hoekstra M, Dijk D, et al. Effect of high-dose dexamethasone on perioperative lactate levels and glucose control: a randomized controlled trial. Crit Care. 2015;19(1):41. https://doi.org/10.1186/s13054-015-0736-9 https://doi.org/10.1186/s13054-015-0736-...
) |
Unspecified surgery/ 148 min |
High dose of intraoperative dexamethasone |
High doses of intraoperative dexamethasone increased postoperative lactate and glucose levels within the first 15 hours of ICU admission. |
2013/ Brazil(3030 Hajjar LA, Almeida JP, Fukushima JT, Rhodes A, Vincent JL, Osawa EA, et al. High lactate levels are predictors of major complications after cardiac surgery. J Thorac Cardiovasc Surg. 2013;146(2):455-60. https://doi.org/10.1016/j.jtcvs.2013.02.003 https://doi.org/10.1016/j.jtcvs.2013.02....
) |
Not mentioned in the study |
A threshold of 3 mmol/L within 6 hours of ICU admission and 2 mmol/L |
After 6 hours of ICU admission, lactate level predicts postoperative complications such as 30-day all-cause mortality and severe morbidity after cardiac surgery in adult patients. |
2011/ Australia(3131 Dong MF, Ma ZS, Wang JT, Chai SD, Tang PZ, Wang LX. Impact of peripherally established cardiopulmonary bypass on regional and systemic blood lactate levels. Heart Lung Circ. 2012;21(3):154-8. https://doi.org/10.1016/j.hlc.2011.10.014 https://doi.org/10.1016/j.hlc.2011.10.01...
) |
Unreferenced type/ 50 to 100 min |
Increase in lactate associated with CPB time |
In patients who received CPB for two hours or more, venous lactate and PvCO2 were higher than baseline values. |
2011/ India(3232 Kapoor P, Mandal B, Chowdhury U, Singh S, Kiran U. Changes in myocardial lactate, pyruvate and lactate-pyruvate ratio during cardiopulmonary bypass for elective adult cardiac surgery: early indicator of morbidity. J Anaesthesiol Clin Pharmacol. 2011;27(2):225-32. https://doi.org/10.4103/0970-9185.81819 https://doi.org/10.4103/0970-9185.81819...
) |
Myocardial revascularization and valve surgery/ > 60 min |
CPB time |
Pre-CPB myocardium, lactate value 2.9 mmol/l, myocardial pyruvate value of 0.07 mmol/l can predict post-CPB inotropic need with good sensitivity and specificity. |
2006/ Sweden(3333 Svenmarker S, Häggmark S, Ostman M. What is a normal lactate level during cardiopulmonary bypass?. Scand Cardiovasc J. 2006;40(5):305-11. https://doi.org/10.1080/14017430600900261 https://doi.org/10.1080/1401743060090026...
) |
Myocardial revascularization/ 90.2 min |
Age, use of vasoactive drugs, CPB time, aortic clamping time |
In patients who met the criteria for hyperlactatemia, in-hospital mortality was 13.3%, compared with 2.2% for the entire cohort. |