title: Factors affecting on serum lactate after cardiac surgery.
abstract: BACKGROUND
  The relation between elevated blood lactate level and mortality and morbidity rates after coronary bypass surgery is a proven subject. One of the factors that seems to affect directly the blood lactate level is the storage duration of packed red blood cells.
  
  
  OBJECTIVE
  This study aimed to evaluate the effect of storage duration of transfused blood on serum lactate during cardiac surgery and up to 24 hours after that in the ICU.
  
  
  METHODS
  In a cross-sectional study, 228 patients referred to three hospitals of Mashhad University of Medical Sciences for open cardiac surgery, was enrolled using systematic random sampling method. Immediately after accessing arterial line, the first sample of arterial blood gas (ABG) was obtained. For evaluation of lactate levels, the next samples were obtained at the end of surgery and after 24 hours of staying ICU.
  
  
  RESULTS
  Among 5 factors which affected lactate level during surgery, diabetes and higher ejection fraction (EF) reduced changes of the lactate level. On the other hand, the number of infused blood units, duration of on-pump time, and the mean storage duration of blood units were associated with elevated serum lactate during surgery. A significant relationship was found between blood storage duration and serum lactate levels 24 hours after surgery.
  
  
  CONCLUSIONS
  Comparing the serum lactate level before operation and 24 hours after the operation showed that the number of received blood units had a significant effect on serum lactate. We found no significant effect for blood storage duration; however, the number of given blood units was more significant.
authors: Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Marjan
authors: M
authors: Joudi
authors: Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Mehdi
authors: M
authors: Fathi
authors: Cardiac Anesthesia Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Ghasem
authors: G
authors: Soltani
authors: Department of Radiologic Technology, Faculty of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
authors: Azra
authors: A
authors: Izanloo
keywords: Blood, Cardiac Surgical Procedures; Lactates
references: PLoS One. 2010 Oct 21;5(10):e13551
references: 21042411
references: Eur J Anaesthesiol. 2001 Sep;18(9):576-84
references: 11553252
references: N Engl J Med. 2008 Mar 20;358(12):1229-39
references: 18354101
references: J Surg Res. 2002 Jan;102(1):6-12
references: 11792145
references: Crit Care. 2010;14(4):R149
references: 20684758
references: Transfus Apher Sci. 2013 Oct;49(2):212-22
references: 23402838
references: J Trauma. 2001 Mar;50(3):426-31; discussion 432
references: 11265021
references: Chest. 2003 May;123(5):1361-6
references: 12740248
references: Heart Surg Forum. 2004 Apr 01;7(2):E155-9
references: 15138095
references: Crit Care Med. 2006 Jun;34(6):1608-16
references: 16607235
references: Ann Thorac Surg. 2002 Oct;74(4):1180-6
references: 12400765
references: Crit Care. 2006;10(6):R167
references: 17134504
references: J Thorac Cardiovasc Surg. 1997 Dec;114(6):1042-52
references: 9434699