Volume 12 Supplement 2

28th International Symposium on Intensive Care and Emergency Medicine

Open Access

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

  • S Thanthulage1 and
  • S Stacey1
Critical Care200812(Suppl 2):P449

https://doi.org/10.1186/cc6670

Published: 13 March 2008

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

Lactatemia level

Total

Male (%)

Female (%)

Average age (years)

NoHL

121

100 (40.6)

21 (8.5)

66

MHL

112

89 (36.2)

23 (9.3)

68

SHL

13

10 (4)

3 (1.2)

72

Table 2

Patient length of stay in ITU related to maximum lactate levels in the first 24 hours

Length of stay

NoHL (%)

MHL (%)

SHL (%)

≤ 24 hours

100 (82.6)

72 (64.3)

4 (30.7)

≤ 48 hours

14 (11.6)

23 (20.5)

3 (23.1)

>48 hours

7 (5.7)

17 (15.1)

6 (46.2)

Conclusion

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

Authors’ Affiliations

(1)
London Chest Hospital

References

  1. Micheal JM, et al.: Frequency, risk factors and outcome of hyperlactatemia after cardiac surgery. Chest 2003, 123: 1361-1366. 10.1378/chest.123.5.1361View ArticleGoogle Scholar
  2. Iqbal M, et al.: Effect of cardio pulmonary bypass on lactate metabolism. Intensive Care Med 2003, 29: 1279-1285. 10.1007/s00134-003-1860-6View ArticleGoogle Scholar
  3. Brandis K: Acid–Base Physiology.[http://www.anaesthesiaMCQ.com]

Copyright

© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.

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