الفهرس 
The impact of intraoperative hyperlactatemia on weaning from cardiopulmonary bypass for patients undergoing on pump coronary artery bypass grafting surgery: A Prospective Observational Study
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Abstract
Background: Elevated lactates level frequently occurs during and after cardiac
surgery, and has been classified into early- and late-onset hyperlactatemia. The
aim of the current study was to evaluate the impact of early-onset
hyperlactatemia on weaning from bypass in patients who underwent on pump
coronary artery bypass grafting.
Methods: We performed a prospective single-center study on 300 adult patients
who underwent coronary artery bypass grafting surgery. Patients with
associated comorbidities such as uncontrolled diabetes mellitus, low
hemoglobin level, hemodynamic instability before surgery were excluded.
Arterial blood lactate level was measured one hour before induction, before and
immediately after weaning from CPB and upon admission to ICU. The lactate values were evaluated together with clinical data and duration of post-operative
mechanical ventilation. Patients were classified into 2 groups according to their
peak arterial lactate level: group N [lactate ˂4 mmol/l (n = 238)] and group H
[hyperlactatemia, lactate ˃4 mmol/l (n = 62)].
Results: When comparing outcomes across both groups, early-onset
hyperlactatemia was correlated with adverse outcomes including higher need
and doses of inotropes and vasopressors, worse hemodynamic parameters,
prolonged mechanical ventilation.
Conclusion: Intraoperative hyperlactatemia negative affects the ease of
weaning from cardiopulmonary bypass in patients undergoing on pump
coronary artery bypass grafting surgery.
Key words: level frequently occurs during and after cardiac surgery, and has been classified into early