title: The impact of hyperlactatemia on postoperative outcome after adult cardiac surgery.
abstract: OBJECTIVE
  To evaluate the value of blood lactate value in predicting postoperative mortality (primary outcome), duration of ventilation, and length of stay in an intensive care unit (ICU) and hospital (secondary outcomes).
  
  
  METHODS
  We performed a prospective observation study on 1,820 consecutive patients undergoing open heart surgery in a tertiary university medical center. Blood lactate levels were obtained from patients on admission to the cardiac surgical ICU and measured serially.
  
  
  RESULTS
  All patients were divided into three groups according to their maximum blood lactate levels: group I (normolactatemia, lactate ≤2.2 mmol/l), 332 patients; group II (mild hyperlactatemia, lactate 2.2-4.1 mmol/l), 1,054 patients; and group III (severe hyperlactatemia, lactate ≥4.4 mmol/l), 434 patients. Maximum blood lactate levels ≥4.4 mmol/l during the first 10 h post admission were associated with prolonged ventilation time, longer ICU stay, and increased mortality (P < 0.001).
  
  
  CONCLUSIONS
  Hyperlactatemia is common after cardiac surgery. Maximal lactate threshold ≥4.4 mmol/l in the first 10 h after operation accurately predicts postoperative mortality.
authors: Department of Cardiothoracic Surgery, Sheba Medical Center, Tel Hashomer, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Hashomer, 52621 Tel Aviv, Israel. alexanderkogan140@hotmail.com
authors: Alexander
authors: A
authors: Kogan
authors: Sergey
authors: S
authors: Preisman
authors: Alex
authors: A
authors: Bar
authors: Leonid
authors: L
authors: Sternik
authors: Jacob
authors: J
authors: Lavee
authors: Ateret
authors: A
authors: Malachy
authors: Dan
authors: D
authors: Spiegelstein
authors: Haim
authors: H
authors: Berkenstadt
authors: Ehud
authors: E
authors: Raanani
mesh_terms: D000137:Acid-Base Imbalance / Q000209:etiology / Q000401:mortality*; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D019344:Lactic Acid / Q000097:blood*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D014691:Ventilation
chemical_list: D019344:Lactic Acid