Why the study?
What is the etiology, prognostic value, and optimal management of lactate elevation during and after major cardiac surgery in adults?
What is the etiology, prognostic value, and optimal management of lactate elevation during and after major cardiac surgery in adults?
This review highlights that while elevated lactate after cardiac surgery is a strong prognostic marker for adverse outcomes, evidence guiding its optimal management remains limited.
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Elevated lactate may aid risk stratification after cardiac surgery; leaves open optimal management pending prospective trials.
Elevated lactate is a common occurrence after cardiac surgery. This review summarizes the literature on the complex etiology of lactate elevation during and after cardiac surgery, including considerations of oxygen delivery, oxygen utilization, increased metabolism, lactate clearance, medications and fluids, and postoperative complications. Second, the association between lactate and a variety of outcomes are described, and the prognostic role of lactate is critically assessed. Despite the fact that elevated lactate is strongly associated with many important outcomes, including postoperative complications, length of stay, and mortality, little is known about the optimal management of postoperative patients with lactate elevations. This review ends with an assessment of the limited literature on this subject.
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Lars W. Andersen (2017) studied this question.
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