The relationship between serum lactate and VO2/VCO2 in patients undergoing coronary artery bypass grafting in Ardabil city hospital, 2017
Keywords:VO2/VCO2, Blood lactate, Coronary artery bypass graft
Background: VO2/VCO2 ratio and blood lactate are different indices of adequacy of oxygen delivery to oxygen needs. The aim of this study was to investigate the relationship between serum lactate and VO2/VCO2 in patients undergoing CABG in Ardabil city.
Methods: This descriptive-analytical study was performed on 30 patients who underwent CABG at Ardabil city hospital during 2017. Demographic data of patients including age and sex were collected. Standard monitoring included electrocardiogram, invasive arterial pressure, pulse oximetry, end tidal carbon dioxide, temperature and urine output was done. The CAB was carried out through a CPB pump at the time of grafting. Blood lactate and VO2/VCO2 were measured in 3 groups of patients based on number of grafts, EF and serum Creatinine. Collected data analyzed by statistical methods in SPSS version 19.
Results: Most of patients were male (86.7%). The mean age of patients was 58.1 years. The blood lactate and VO2/VCO2 values increased after surgery. There was no statistically significant difference in two groups based on number of grafts and serum Cr but it was statistically significant based on E/F. There was a significant correlation between Blood lactate and VO2/VCO2 ratio in patients.
Conclusions: The results showed that blood lactate as an indicator for patients status during CABG surgery can be replaced with VO2/VCO2.
Gaziano TA. Reducing the growing burden of cardiovascular disease in the developing world. Health Aff (Millwood). 2007;26(1):13-24.
Hasanshiri F, Pourabbasi MS, Mousavi GA, Fatahi M, Kianfar AA, Seyedi HR, et al. Association between serum lactate and postoperative outcomes following coronary artery bypass graft surgery. Feyz. 2017;20(6):518-24.
Li H, Cang J, Zhang X. Sevoflurane exerts a more marked influence compared with propofol on gene expression in patients undergoing coronary artery bypass graft surgery. Exp Ther Med. 2016;11(2):448-54.
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine, 19e. USA 2015.
Braunwalds Heart disease, a text book of Cardiovascular medicine, 9th edition, 2015.
Ray S, Mazumder A, Kumar S, Bhattacharjee P, Rozario D, Bandyopadhyay S, et al. Angioplasty of unprotected left main coronary stenosis: Real world experience of a single-operator group from eastern India. Indian heart J. 2016;68(1):28-35.
Kamalakkannan GS, Karthekeyan R, Vakamudi M, Bangale S, Kodali R, Nayagam H, et al. Correlation of Blood Lactate and Mixed Venous Oxygen Saturation in Off-Pump CABG. World J Cardiovasc Surg. 2014;50(2):144-35.
Hu BY, Laine GA, Wang S, Solis RT. Combined central venous oxygen saturation and lactate as markers of occult hypoperfusion and outcome following cardiac surgery. J Cardiothor Vasc Anesthesia. 2012;26(1):52-7.
Reinhart K, Rudolph T, Bredle DL. Comparison of centralvenous to mixed-venous oxygen saturation during changes in oxygen supply/demand. Chest. 1989;95:1216-21.
Pearse RM, Rhodes A. Mixed and central venous oxygen saturation, in Vincent JL (ed): Yearbook of Intensive Care and Emergency Medicine. Berlin, Germany, Springer; 2005: 592-602.
Mustafa I, Roth H, Hanafiah A, Hakim T, Anwar M, Siregar E, et al. Effect of cardiopulmonary bypass on lactate metabolism. Intensive Care Med.2003;29:1279–85
Rao V, Ivanov J, Weisel R, Cohen G, Borger M, Mickle D. Lactate release during reperfusion predicts low cardiac output syndrome after coronary bypass surgery. Ann Thoracic Surg.2001;71(6):1925-30.
Davies A, Bellomo R, Raman J, Gutteridge G, Buxton B. High lactate predicts the failure o intraaortic balloon pumping after cardiac surgery. Ann Thoracic Surg. 2001;71(5):1415-20.
14.Laine GA, Hu BY, Wang S, Solis RT, Reul GJ. Isolated high lactate or low central venous oxygen saturation after cardiac surgery and association with outcome. Journal of cardiothoracic and vascular anesthesia. 2013 Dec 31;27(6):1271-6.
Heinze H, Paarmann H, Heringlake M, Groesdonk HV. Measurement of central and mixed venous-to-arterial carbon dioxide differences in cardiac surgery patients. Appl Cardiopulm Pathophysiol. 2011;15:29-37.
Holm J, Håkanson E, Vánky F, Svedjeholm R. Mixed venous oxygen saturation predicts short-and long-term outcome after coronary artery bypass grafting surgery: a retrospective cohort analysis. British J Anaesthesia. 2011;107(3):344-50.
Ranucci M, Isgrò G, Carlucci C, De La Torre T, Enginoli S, Frigiola A. Central venous oxygen saturation and blood lactate levels during cardiopulmonary bypass are associated with outcome after pediatric cardiac surgery. Critical Care. 2010;14(4):R149.
Ozgoz HM, Yuksel A, Tok M, Bicer M, Signak IS. Relationship between Serum Lactate Levels and Postoperative Outcomes in Patients undergoing On-Pump Coronary Bypass Surgery. Int J Clin Cardiol Res. 2017;1(1):015-9.
Engoren M, Evans M. Oxygen consumption, carbon dioxide production and lactic acid during normothermic cardiopulmonary bypass. Perfusion. 2000;15(5):441-6.