title: Impact of peripherally established cardiopulmonary bypass on regional and systemic blood lactate levels.
abstract: BACKGROUND
  To investigate blood lactate levels during and after peripherally established cardiopulmonary bypass (CPB).
  
  
  METHODS
  In 86 patients (41 males, mean age 13.8 ± 7.2), CPB was established via femoral vein and artery cannulation for thoracoscopic closure of atrial (n=54) or ventricular septal defect (n=32). Arterial and venous blood lactate levels were measured from the cannulated limb during CPB, and from systemic circulation after CPB.
  
  
  RESULTS
  The mean duration of CPB and cannulation of a lower extremity were 50.0 ± 10.5 min and 76.0 ± 18.5 min, respectively. The mean arterial lactate level measured from the systemic circulation remained unchanged during CPB (P>0.05). In patients with CPB for 3h or more, mean arterial lactate in the cannulated limb were higher than the baseline values (3.3 ± 0.5 vs 0.8 ± 0.2 mmol/L, P<0.05). In patients with more than 2h of CPB, mean venous lactate levels in the cannulated limb were also higher than the baseline values (3.4 ± 0.2 vs 1.1 ± 0.3 mmol/L, P<0.05). Within 6h after CPB, systemic arterial (3.0 ± 0.2 vs 0.8 ± 0.1 mmol/L, P<0.01) and venous lactate levels (6.5 ± 0.2 vs 1.0 ± 0.1 mmol/L, P<0.01) were higher than the pre-CPB values.
  
  
  CONCLUSIONS
  Peripherally established CPB was associated with an arterial and venous lactate elevation in local and systemic circulation. The duration of CPB and lower limb cannulation appears to be related to the lactate elevation.
authors: Department of Cardiac Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong 252000, PR China.
authors: Ming-Feng
authors: MF
authors: Dong
authors: Zeng-Shan
authors: ZS
authors: Ma
authors: Jian-Tang
authors: JT
authors: Wang
authors: Shou-Dong
authors: SD
authors: Chai
authors: Pei-Zhe
authors: PZ
authors: Tang
authors: Le-Xin
authors: LX
authors: Wang
mesh_terms: D000140:Acidosis, Lactic / Q000097:blood*; D000293:Adolescent; D000328:Adult; D002245:Carbon Dioxide / Q000378:metabolism; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D013906:Thoracoscopy / Q000379:methods*; D013997:Time Factors; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide; D019344:Lactic Acid