A clinical research of factors relating to hyperlactatemia for post CABG patient / 中华胸心血管外科杂志

ABSTRACT

Objective To research the factors relating to hyperlactatemia and its connections to certain combinations and the motality of post CABG patients.Methods Splitting the 1 280 cases of post OPCABG surgery patient admitted to ICU of Anzhen Hospital between March 2016 and October 2016 into two groups,including a hyperlactatemia group of 511 patients [340 males and 171 females,aged (63.81 ± 9.1)years],and a none-hyperlactatemia group of 769 samples [499 males and 270 females,aged(61.72 ± 8.97) years].Recording the pre-operative characteristics such as gender,age,medical history,heart function,and post-operative characteristics such as liver and kidney function,reintubation rate,tracheotomy treatment rate,mortality rate,IABP and ECMO usage rates,ICU and hospital stay time.Results As compare to the none-hyperlactatemia group,the hyperlactatemia group has(1) higher reintubation rate(P =0.003) and higher tracheotomy rate (P =0.035);(2) longer mechanical ventilation time (P =0.009);(3) higher mortality rate (P =0.000);(4) longer ICU stay time (P =0.039) and hospital stay time(P =0.047).Multi factor regression discoveredpre-operative IABP(P =0.040),postoperative cadiogenic shock (P =0.030),post-operative AKI (P =0.020),post-operative liver failure (P =0.039) are the independent risk factors for post-operative hyperlactatemia of CABG patient;peak lactate time ＞ 30 h (P =0.021),post-operative level 3 AKI (P =0.030),post-operative liver failure (P =0.025),post-operative cardiogenic shock (P =0.037) are the independent risk factors for mortality of CABG post-operative hyperlactatemia patient.Conclusion After CABG operation,hyperlactatemia patients had a higher mortality rate.Timely restoring heart and important organ function to remove lactate so to reduce mortality rate is advised.