Hyperlactatemia and worse outcomes in patients undergoing cardiac surgery: a retrospective cohort study
DOI:
https://doi.org/10.33159/25959484.repen.2023v33a03Palavras-chave:
Perioperative procedures, Hyperlactatemia, Hospital mortality, Critical care outcomesResumo
Objective: Identify the factors, complications, and outcomes associated with hyperlactatemia in patients undergoing cardiac surgery. Methods: A retrospective cohort study including patients with hyperlactatemia admitted to the surgical intensive care unit (SICU) immediately after cardiac surgery. Patients were divided into 2 groups based on baseline lactate levels: hyperlactatemia group (HL, lactate levels ≥ 3 mmol/L) and normal lactate group (NL, lactate levels < 3 mmol/L). Results: Of 1304 patients, 589 (45.2%) had hyperlactatemia in the postoperative period of cardiac surgery. The LH group when compared to the NL group, respectively, presented a higher mean value for the EuroSCORE (3.5 ± 2.4 vs 3.2 ± 2.3, p = 0.018), higher mortality rates (13.6% vs 3.9%, p <0.001), acute kidney injury (52.6% vs. 36.8%; p <0.001), longer ICU stay (4 days [3 - 6]) vs. 5 days [3 - 7]; p <0.001), required mechanical ventilation for longer in the first 24 hours (9.4% vs. 18.1%; p <0.001) and 48 hours (7.7% vs. 15.1%; p <0.001 ) after admission to the ICU and had higher rates of use of IABP (8.1% vs. 5.5%; p = 0.034). The survival curves show that the overall survival was better in the patients in the NL group. Conclusions: In the postoperative period of cardiac surgery, the prevalence of hyperlactatemia was 45.2% with worse outcomes for this group. Patients in the HL group had higher mortality, higher frequency of mechanical ventilation in the first 24 and 48 hours, higher incidence of acute kidney injury, more need for the use of IABP, and longer length of stay SICU.
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