What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiac surgery (n=591). Intervention: 24-hour lactate clearance vs. Lower lactate clearance. Primary outcome: Mortality after cardiopulmonary bypass (OR 0.985, 95% CI 0.973-0.998, p=0.021).

January 1, 2019Turkiye Klinikleri Cardiovascular SciencesOpen Access

In patients undergoing cardiac surgery, 24-hour lactate clearance was an independent predictor of mortality (OR 0.985), whereas peak lactate levels were not significantly associated with mortality.

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Why the study?

Because single lactate measurements may not give sufficient information, the study evaluated whether dynamic lactate clearance is useful in predicting mortality and morbidity after cardiac surgery.

Does lactate clearance predict mortality and morbidity better than static lactate levels in patients undergoing cardiac surgery?

Population

591 patients who underwent cardiovascular surgery

Comparison

Highest lactate level <4 vs highest lactate level >= 4

Design

Retrospective cohort study

Follow-up

28 days

Key result

In patients undergoing cardiac surgery, 24-hour lactate clearance was an independent predictor of mortality (OR 0.985), whereas peak lactate levels were not significantly associated with mortality.

Authors

GPGülçin Patmano TBTuğba BİNGÖL MTMehmet Tercan

Discussion

Member takes

Overview

May support lactate clearance for postoperative risk stratification in cardiac surgery; hypothesis-generating and requires prospective validation.

Study Design

Type

Cohort (n=591)

Multicenter

Structured PICO

Does lactate clearance predict mortality and morbidity better than static lactate levels in patients undergoing cardiac surgery?

Population

591 patients undergoing cardiac surgery, excluding those with hepatic or renal dysfunction and those who died within 72 hours, evaluated retrospectively for 28-day mortality.

Exposure

Highest postoperative lactate level ≥ 4 mmol/L (Group 2) and evaluation of 24-hour and 72-hour lactate clearance.

Comparator

Highest postoperative lactate level < 4 mmol/L (Group 1).

Outcome

Mortality within 28 days and morbidity (duration of intensive care unit stay, total duration of hospital stay).hard clinical

Main Result

Odds Ratio: 0.985 (95% CI 0.973–0.998)

p-value: p=0.021

Dynamic lactate parameters, specifically 24-hour lactate clearance, are more useful than static peak lactate levels in predicting mortality after cardiac surgery.

Limitations

Retrospective study from a single center.
Blood gas sampling times varied among patients.
Lactate clearances at 6th and 12th hours were not determined.
ICU stay duration was affected by a hospital procedure requiring a minimum 3-day stay.
Inotropic and vasoactive drug selection was not standardized.
Retrospective study and data collected from a single center.
Hours of blood gases taken varied among patients.
No difference in duration of intensive care stay may be due to hospital procedure (patients not allowed to leave ICU before 3 days).
Patient management and selection of inotropic/vasoactive drugs were left to the physician's choice and could not be standardized.

Cite This Study

Patmano et al. (2019) conducted a cohort in Cardiac surgery (n=591). 24-hour lactate clearance vs. Lower lactate clearance was evaluated on Mortality after cardiopulmonary bypass (OR 0.985, 95% CI 0.973-0.998, p=0.021). In patients undergoing cardiac surgery, 24-hour lactate clearance was an independent predictor of mortality (OR 0.985), whereas peak lactate levels were not significantly associated with mortality.

synapsesocial.com/papers/6a75b91c50ae15bd7fd37981 https://doi.org/10.5336/cardiosci.2019-70462

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January 1, 2019Turkiye Klinikleri Cardiovascular SciencesOpen Access

In patients undergoing cardiac surgery, 24-hour lactate clearance was an independent predictor of mortality (OR 0.985), whereas peak lactate levels were not significantly associated with mortality.

View Full Paper

Ask AI

Bookmark

Why the study?

Because single lactate measurements may not give sufficient information, the study evaluated whether dynamic lactate clearance is useful in predicting mortality and morbidity after cardiac surgery.

Does lactate clearance predict mortality and morbidity better than static lactate levels in patients undergoing cardiac surgery?

Population

591 patients who underwent cardiovascular surgery

Comparison

Highest lactate level <4 vs highest lactate level >= 4

Design

Retrospective cohort study

Follow-up

28 days

Key result

In patients undergoing cardiac surgery, 24-hour lactate clearance was an independent predictor of mortality (OR 0.985), whereas peak lactate levels were not significantly associated with mortality.

Authors

GPGülçin Patmano TBTuğba BİNGÖL MTMehmet Tercan

Discussion

Member takes

Overview

May support lactate clearance for postoperative risk stratification in cardiac surgery; hypothesis-generating and requires prospective validation.

Study Design

Type

Cohort (n=591)

Multicenter

Structured PICO

Does lactate clearance predict mortality and morbidity better than static lactate levels in patients undergoing cardiac surgery?

Population

591 patients undergoing cardiac surgery, excluding those with hepatic or renal dysfunction and those who died within 72 hours, evaluated retrospectively for 28-day mortality.

Exposure

Highest postoperative lactate level ≥ 4 mmol/L (Group 2) and evaluation of 24-hour and 72-hour lactate clearance.

Comparator

Highest postoperative lactate level < 4 mmol/L (Group 1).

Outcome

Mortality within 28 days and morbidity (duration of intensive care unit stay, total duration of hospital stay).hard clinical

Main Result

Odds Ratio: 0.985 (95% CI 0.973–0.998)

p-value: p=0.021

Dynamic lactate parameters, specifically 24-hour lactate clearance, are more useful than static peak lactate levels in predicting mortality after cardiac surgery.

Limitations

Retrospective study from a single center.
Blood gas sampling times varied among patients.
Lactate clearances at 6th and 12th hours were not determined.
ICU stay duration was affected by a hospital procedure requiring a minimum 3-day stay.
Inotropic and vasoactive drug selection was not standardized.
Retrospective study and data collected from a single center.
Hours of blood gases taken varied among patients.
No difference in duration of intensive care stay may be due to hospital procedure (patients not allowed to leave ICU before 3 days).
Patient management and selection of inotropic/vasoactive drugs were left to the physician's choice and could not be standardized.

Cite This Study

synapsesocial.com/papers/6a75b91c50ae15bd7fd37981 https://doi.org/10.5336/cardiosci.2019-70462

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