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Intraoperative lactate levels and postoperative complications of pediatric cardiac surgery.
Alves, Rodrigo Leal; Aragão e Silva, André Luiz; Kraychete, Nadja Cecília de Castro; Campos, Guilherme Oliveira; Martins, Marcelo de Jesus; Módolo, Norma Sueli Pinheiro.
Afiliação
  • Alves RL; São Rafael Hospital, Universidade Federal da Bahia (UFBA), Bahia, Brazil. peres@mail.com
Paediatr Anaesth ; 22(8): 812-7, 2012 Aug.
Article em En | MEDLINE | ID: mdl-22409574
OBJECTIVES: Correlate arterial lactate levels during the intraoperative period of children undergoing cardiac surgery and the occurrence of complications in the postoperative period. AIM: Arterial lactate levels can indicate hypoperfusion states, serving as prognostic markers of morbidity and mortality in this population. BACKGROUND: Anesthesia for cardiac pediatric surgery is frequently performed on patients with serious abnormal physiological conditions. During the intraoperative period, there are significant variations of blood volume, body temperature, plasma composition, and tissue blood flow, as well as the activation of inflammation, with important pathophysiological consequences. METHODS/MATERIALS: Chart data relating to the procedures and perioperative conditions of the patients were collected on a standardized form. Comparisons of arterial lactate values at the end of the intraoperative period of the patients that presented, or not, with postoperative complications and frequencies related to perioperative conditions were established by odds ratio and nonparametric univariate analysis. RESULTS: After surgeries without cardiopulmonary bypass (CPB), higher levels of arterial lactate upon ICU admission were observed in patients who had renal complications (2.96 vs 1.31 mm) and those who died (2.93 vs 1.40 mm). For surgeries with CPB, the same association was observed for cardiovascular (2.90 mm × 2.06 mm), renal (3.34 vs 2.33 mm), respiratory (2.98 vs 2.12 mm) and hematological complications (2.99 vs 1.95 mm), and death (3.38 vs 2.40 mm). CONCLUSION: Elevated intraoperative arterial lactate levels are associated with a higher morbidity and mortality in low- and medium-risk procedures, with or without CPB, in pediatric cardiac surgery.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Ácido Láctico / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Etiology_studies / Risk_factors_studies Idioma: En Revista: Paediatr Anaesth Assunto da revista: ANESTESIOLOGIA / PEDIATRIA Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Brasil País de publicação: França

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Ácido Láctico / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Etiology_studies / Risk_factors_studies Idioma: En Revista: Paediatr Anaesth Assunto da revista: ANESTESIOLOGIA / PEDIATRIA Ano de publicação: 2012 Tipo de documento: Article País de afiliação: Brasil País de publicação: França