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Effects of postoperative hyperlactatemia on patients' intensive therapy unit length of stay

Introduction

Lactate is one of the most crucial intermediates of carbohydrate and nonessential amino acid metabolism. Moderate hyperlactatemia in the immediate postoperative cardiac surgical period is associated with a high risk of major complications [1, 2].

Methods

We audited 246 unselected, consecutive postoperative patients who were admitted post cardiac surgery over 3 months via interrogation of the blood gas analysis machine at the London Chest Hospital. Patients were divided into three groups according to lactate levels for their first 24 hour stay on the intensive therapy unit (ITU): normal up to 2 mmol/l (NoHL), moderate 2.1–4.9 mmol/l (MHL), severe hyperlactatemia >5 mmol/l (SHL) [3]. The length of stay in the ITU was also identified.

Results

See Tables 1 and 2.

Table 1 Normal, moderate and severe hyperlactatemia groups
Table 2 Patient length of stay in ITU related to maximum lactate levels in the first 24 hours

Conclusion

We can confirm that hyperlactatemia during the first 24 hours post cardiac surgery is associated with a prolonged ITU stay.

References

  1. 1.

    Micheal JM, et al.: Frequency, risk factors and outcome of hyperlactatemia after cardiac surgery. Chest 2003, 123: 1361-1366. 10.1378/chest.123.5.1361

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    Iqbal M, et al.: Effect of cardio pulmonary bypass on lactate metabolism. Intensive Care Med 2003, 29: 1279-1285. 10.1007/s00134-003-1860-6

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  3. 3.

    Brandis K: Acid–Base Physiology.[http://www.anaesthesiaMCQ.com]

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Thanthulage, S., Stacey, S. Effects of postoperative hyperlactatemia on patients' intensive therapy unit length of stay. Crit Care 12, P449 (2008). https://doi.org/10.1186/cc6670

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Keywords

  • Carbohydrate
  • Lactate
  • Major Complication
  • Acid Metabolism
  • Unit Length