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February 9, 2021Cardiology in the Young

Hyperlactataemia as a predictor of adverse outcomes post-cardiac surgery in neonates with congenital heart disease

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Key result

A risk model incorporating delta lactate and single ventricle status predicted early morbidity and mortality in neonates following cardiac surgery with good discrimination (AUC 0.79; 95% CI 0.75-0.89).

Why the study?

To evaluate the discriminative ability of hyperlactataemia for early morbidity and mortality following cardiac surgery in neonates with CHD.

Does hyperlactataemia predict early morbidity and mortality in neonates with congenital heart disease following cardiac surgery?

Population

432 neonates undergoing cardiac surgery on cardiopulmonary bypass at a tertiary care children's hospital

Comparison

Postoperative lactate levels and trajectories

Design

Retrospective observational study

Follow-up

30 days

Authors

EVEleonore ValenciaBoston Children's HospitalSSSteven J. StaffaBoston UniversityMNMeena NathanCardiac Surgery

Discussion

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Member takes

Overview

May aid postoperative risk stratification in neonates with CHD; leaves open whether lactate-guided interventions improve outcomes.

Study Design

Type

Observational (n=432)

Multicenter

No

Structured PICO

Does hyperlactataemia predict early morbidity and mortality in neonates with congenital heart disease following cardiac surgery?

P
Population
432 neonates with congenital heart disease who underwent cardiac surgery on cardiopulmonary bypass, evaluated for early morbidity and mortality.
E
Exposure
Hyperlactataemia (peak lactate within 48 hours, increase in lactate from ICU admission through 12 hours)
O
Outcome
Composite of ≥1 of the following: cardiac arrest or extracorporeal membrane oxygenation within 72 hours or 30-day mortality post-operativelycomposite

Delta lactate in the immediate post-operative period combined with single ventricle status can prognosticate the risk of early morbidity and mortality in neonates undergoing cardiac surgery.

Cite This Study

Valencia et al. (2021) conducted an observational in congenital heart disease (n=432). Lactate levels (peak and delta) was evaluated on Composite of cardiac arrest or extracorporeal membrane oxygenation within 72 hours or 30-day mortality post-operatively. A risk model incorporating delta lactate and single ventricle status predicted early morbidity and mortality in neonates following cardiac surgery with good discrimination (AUC 0.79; 95% CI 0.75-0.89).

synapsesocial.com/papers/6a93a29206b85605447c0480https://doi.org/10.1017/s1047951121000263
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Lactate levels predict mortality and need for peritoneal dialysis in children undergoing congenital heart surgery2011 · 27 citations
  2. 2Predicting major adverse events after cardiac surgery in children2008 · 50 citations
  3. 3Serum lactate clearance as a predictor of outcome in infants' postcardiac surgery2022
  4. 4Hyperlactatemia in patients undergoing adult cardiac surgery under cardiopulmonary bypass: Causative factors and its effect on surgical outcome2016 · 50 citations
  5. 5Intraoperative changes in blood lactate levels are associated with worse short-term outcomes after cardiac surgery with cardiopulmonary bypass2019 · 25 citations