RRML - Coronary Sinus Lactate as Marker of Myocardial Ischemia in Cardiac Surgery: Correlation with Morbidity and Mortality after Cardiac Surgery
AMLR

ISSN online: 2284-5623

ISSN-L: 1841-6624

Rejection rate (2020): 75%

Română English

Journal Metrics

Impact Factor 0.5
Five Year Impact Factor 0.5
JCI 0.12

Advanced search

Top 10 downloaded articles
- April 2024 -
 
A comprehensive review of Prof... 24
Recomandarea comună EFLM-COLA... 14
Monocyte to high-density lipop... 10
Anti-thyroid peroxidase (TPO) ... 10
Understanding the key differen... 9
Understanding the pathogenesis... 7
Romanian Review of Laboratory ... 6
Function of the S1P pathway in... 6
Predictive value of expression... 6
Comparison of two analytical m... 5

Log in

Concept, Design & Programming
Dr. Adrian Man
   
 
Nr. 23(2)/2015 DOI:10.1515/rrlm-2015-0019
XML
TXT

Coronary Sinus Lactate as Marker of Myocardial Ischemia in Cardiac Surgery: Correlation with Morbidity and Mortality after Cardiac Surgery

Victor Raicea, Judit Kovacs, Liviu Moraru, Horatiu Suciu


Abstract:

Introduction. Perioperative myocardial injuries are one of the most frequent causes of morbidity and mortality after cardiac surgery, the most common etiology being the poor myocardial protection during aortic crossclamp. During aortic crossclamp progressive accumulation of lactate and intracellular acidosis are well-known phenomena, and are associated with alteration of myocardial contractile function. Our objective was to study the coronary sinus lactate levels as a predictor of postoperative hemodynamic outcome in open-heart surgical patients. Material and methods. We performed a prospective clinical trial, including 142 adult patients with elective cardiac surgery. Anterograde cardioplegia was administered in 82 patients, retrograde cardioplegia in 60 (in 30 patients it was administrated intermittently and in 30 continuously). Blood was collected simultaneously from the aortic cardioplegic line (inflow) and from coronary sinus or the aortic root (outflow) before aortic crossclamp, after crossclamp at every 10 minutes and after crossclamp removal at 0 and 10 minutes. All patients were operated on cardiopulmonary bypass with cardiac arrest, using warm-blood cardioplegia for cardioprotection. Results. Lactate levels showed increasing values during aortic crossclamp, and a rapid decline after crossclamp removal. The incidence of low cardiac output was significantly higher in patients with lactate levels that exceeded 4 mmol/L. In patients who died in the postoperative period, lactate level was even higher (5 mmol/L), with only a modest recovery after crossclamp removal. Conclusion. Monitoring lactate level in coronary sinus blood is a reliable method and has a good prognostic value regarding postoperative morbidity and mortality in open heart surgery.

Keywords: cardiac surgery;myocardial injuries;coronary sinus;lactate levels

Received: 28.2.2015
Accepted: 28.4.2015
Published: 9.6.2015

 
  PDF Download full text PDF
(457 KB)
     
 
How to cite
Raicea V, Kovacs J, Moraru L, Suciu H. Coronary Sinus Lactate as Marker of Myocardial Ischemia in Cardiac Surgery: Correlation with Morbidity and Mortality after Cardiac Surgery. Rev Romana Med Lab. 2015;23(2):189-97. DOI:10.1515/rrlm-2015-0019