Relationship between intraoperative serum lactate and hemoglobin levels on postoperative renal function in patients undergoing elective cardiac surgery

Mitchell, Stephen C.; Vinnakota, Anirudh; Deo, Salil V.; Markowitz, Alan H.; Sareyyüpoğlu, Başar; Elgudin, Yakov; Medalion, Benjamin; Tzagournis, Adam; Sabik, Joseph F.

doi:10.1111/jocs.13713

Cited by 14 publications

(12 citation statements)

References 13 publications

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“…This is similar to other studies in septic patients and patients undergoing cardiac surgery in whom elevated lactic acid levels were associated with acute kidney injury. 23,24 We found that both exogenous catecholamines and longer CPB were associated with higher lactic acid levels. Both of these factors have previously been associated with postoperative acute kidney injury in other surgical groups.…”

Section: Commentmentioning

confidence: 79%

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Worrell

Haug

Dubovoy

et al. 2020

The Annals of Thoracic Surgery

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Background. Elevated lactate levels may be caused by increased production suggestive of tissue ischemia; however, they may also occur without evidence of ischemia, by catecholamine activation of beta receptors. The purpose of this study was to determine the factors associated with increased lactate levels during and after lung transplantation and to evaluate whether lactate levels were associated with increased time to extubation and postoperative complications.Methods. This was a retrospective study of patients who underwent lung transplantation between January 2015 and May 2017 at the University of Michigan, Ann Arbor, MI. Multivariable linear regression was used to determine the factors associated with peak lactate levels and to find the associations between lactate levels and outcomes of nitric oxide time, intubation time, length of stay, and creatinine level. Logistic regression was used to determine the associations between lactate levels and acute kidney injury and atrial fibrillation.Results. A total of 86 patients underwent singlelung transplantation (n [ 17; 20%

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Section: Commentmentioning

confidence: 79%

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Worrell

Haug

Dubovoy

et al. 2020

The Annals of Thoracic Surgery

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“…Blood lactate can reflect stress intensity and perfusion of organ and tissue. Some recent studies have reported that the level of blood lactate is significantly correlated with hospitalization duration, incidence of complications and risk of death 20,21 . Our trial showed lower lactate and more urine in the patients of TAP + LMA group than in the control group.…”

Section: Discussionmentioning

confidence: 99%

Combined use of transversus abdominis plane block and laryngeal mask airway during implementing ERAS programs for patients with primary liver cancer: a randomized controlled trial

Huang

Chen

Zhu³

et al. 2020

Sci Rep

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The incidence and mortality of primary liver cancer are very high and resection of tumor is the most crucial treatment for it. We aimed to assess the efficacy and safety of combined use of transversus abdominis plane (TAP) block and laryngeal mask airway (LMA) during implementing Enhanced Recovery After Surgery (ERAS) programs for patients with primary liver cancer. This was a prospective, evaluator-blinded, randomized, controlled parallel-arm trial. A total of 96 patients were enrolled (48 in each group). Patients in the control group received general anesthesia with endotracheal intubation, while patients in the TAP + LMA group received general anesthesia with LMA and an ultrasound-guided subcostal TAP block. The primary end-point was postoperative time of readiness for discharge. The secondary end-points were postoperative pain intensity, time to first flatus, quality of recovery (QoR), complications and overall medical cost. Postoperative time of readiness for discharge in the TAP + LMA group [7 (5–11) days] was shorter than that of the control group [8 (5–13) days, P = 0.004]. The postoperative apioid requirement and time to first flatus was lower in the TAP + LMA group [(102.8 ± 12.4) µg, (32.7 ± 5.8) h, respectively] than the control group [(135.7 ± 20.1) µg, P = 0.000; (47.2 ± 7.6) h, P = 0.000; respectively]. The QoR scores were significantly higher in the TAP + LMA group than the control group. The total cost for treatment in the TAP + LMA group [(66,608.4 ± 6,268.4) CNY] was lower than that of the control group [(84,434.0 ± 9,436.2) CNY, P = 0.000]. There was no difference in complications between these two groups. The combined usage of a TAP block and LMA is a simple, safe anesthesia method during implementing ERAS programs for patients with primary liver cancer. It can alleviate surgical stress, accelerate recovery and reduce medical cost.

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“…Researchers involved in a Spanish multicenter cohort study [112] reported that patients with a postoperative hemoglobin (Hb) level <19 g/dL tended to experience CSA-AKI (OR 1.41) after adjusting for intraoperative red blood cell transfusion. An Hb drop after cardiac surgery also contributed to a prolonged hospital length of stay [113]. In addition, iron metabolism may play a role in the pathophysiology of kidney injury.…”

Section: Other Biomarkersmentioning

confidence: 99%

Biomarkers of Acute Kidney Injury after Cardiac Surgery: A Narrative Review

Chen

Yang

2019

BioMed Research International

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Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major and serious complication in patients undergoing cardiac surgery and is independently associated with perioperative mortality and mortality. Therapeutic intervention aiming at reversing kidney dysfunction seems disappointing across multiple settings. Consequently, attention has shifted from treatment to prevention and early detection. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines have unified diagnostic standards mainly based on the serum creatinine (Scr) level or urine output, but neither marker is kidney specific. Efforts have been made to identify novel biomarkers with high sensitivity and specificity. The diagnostic capabilities of neutrophil gelatinase-associated lipocalin (NGAL) and G1 cell cycle arrest biomarker as biomarkers have been confirmed in a large number of clinical trials. The utility of biomarkers of cardiac function and inflammation has been validated in clinical studies. Aiming to offer valuable information for further research, we summarize the progress in defining current markers relevant to CSA-AKI in the last three years.

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Relationship between intraoperative serum lactate and hemoglobin levels on postoperative renal function in patients undergoing elective cardiac surgery

Abstract: In this series, 15% of patients who underwent elective cardiopulmonary bypass developed transient acute renal dysfunction. High lactate levels and low hemoglobin levels during cardiopulmonary bypass were associated with an increased risk of kidney injury.

Cited by 14 publications

References 13 publications

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Is Lactic Acidosis After Lung Transplantation Associated With Worse Outcomes?

Combined use of transversus abdominis plane block and laryngeal mask airway during implementing ERAS programs for patients with primary liver cancer: a randomized controlled trial

Biomarkers of Acute Kidney Injury after Cardiac Surgery: A Narrative Review

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