Document Detail

Effect of cardiopulmonary bypass on lactate metabolism.
MedLine Citation:
PMID:  12845428     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We have investigated the role of cardiopulmonary bypass on lactate metabolism in patients undergoing uncomplicated surgery for elective coronary artery bypass grafting (CABG). DESIGN: Prospective non-randomized observational study. SETTINGS: National Cardiovascular Center. PATIENTS. Three independent groups were studied: preoperative ( n=20), postoperative with bypass (CPB, n=20) and postoperative without bypass (NO-CPB, n=20). INTERVENTIONS: Lactate metabolism was investigated with the use of an exogenous lactate challenge test (2.5 mmol Na-lactate/kg body weight in 15 min). Blood lactate was sequentially determined after the end of infusion. Lactate clearance and endogenous production were estimated from the area under the curve, and a bi-exponential fitting permitted modeling the lactate-decay into two compartments. MEASUREMENTS AND MAIN RESULTS: Lactate metabolism parameters (basal lactate, clearance, endogenous production and half-lives [HL] I and II) were not different between the NO-CPB and preoperative groups. In the CPB group, as compared to the other two groups, basal lactate and endogenous production were not significantly affected while lactate clearance (CPB: 6.02+/-0.97 versus preoperative: 9.41+/-0.93 and NO-CPB: 9.6+/-0.8 ml/kg per min) and HL-I (CPB: 10.6+/-1.4 versus preoperative: 17.2+/-2.3 and NO-CPB: 18.8+/-2.5 min) were decreased ( p<0.001) and HL-II was increased (CPB: 171+/-41 versus preoperative: 73+/-12 and NO-CPB: 48+/-2.9 min, p<0.01). CONCLUSION: While surgery and anesthesia per se do not seem to alter lactate metabolism, CPB significantly decreased lactate clearance, this effect being possibly related to a mild liver dysfunction even in uncomplicated elective surgery.
Iqbal Mustafa; Hubert Roth; Asikin Hanafiah; Tarmizi Hakim; Maizul Anwar; Erwin Siregar; Xavier M Leverve
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Publication Detail:
Type:  Journal Article     Date:  2003-07-05
Journal Detail:
Title:  Intensive care medicine     Volume:  29     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-07     Completed Date:  2005-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-85     Citation Subset:  IM    
Intensive Care Unit, Harapan Kita National Cardiovascular Center, Jakarta, Indonesia.
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MeSH Terms
Cardiopulmonary Bypass*
Lactic Acid / blood*
Middle Aged
Postoperative Care
Preoperative Care
Prospective Studies
Reg. No./Substance:
50-21-5/Lactic Acid

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