| Pulmonary lactate release following cardiopulmonary bypass. | |
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MedLine Citation:
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PMID: 17904857 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The etiology of lung injury following cardiopulmonary bypass (CPB) is multifactorial. Our study focused on quantifying the lactate release from the lungs precipitated by extracorporeal circulation at different time points after the insult. This was complemented by an evaluation of the gas exchange at the level of the alveolar-capillary membrane. METHODS: Forty consecutive patients (age 61+/-11 years, EuroScore 4.7+/-2.7) undergoing CABG were prospectively analyzed. The data are presented as medians and the interquartile range. RESULTS: The pulmonary lactate release (PLR) increased from a baseline value of 0.033 (range -0.077 to 0.170) to 0.465 mmol/min/m2 (range 0.113-0.922), which was seen 6h postoperatively (P<0.001). The A-a O2 gradient increased from 12.7 (range 8.8-15) to 39.1 kPa (range 30.3-46.5) upon discontinuation of CPB (P<0.001). The systemic arterial lactate (LS) concentration increased from 1.22 (range 1-1.44) to 3.03 mmol/l (range 2.29-4.76) 6h after surgery (P<0.001). The veno-arterial pCO2 difference (V-A dpCO2) rose from 0.6 (range 0.5-0.9) to 0.9 kPa (range 0.7-1) (P=0.014). The mortality in the studied group was 5% (2/40). CONCLUSIONS: The lungs were found to be a significant source of lactate, and this pulmonary lactate flux was accentuated by CPB. The PLR correlated with systemic hyperlactatemia as well as the A-a O2 gradient, and was found to be higher in patients requiring prolonged mechanical ventilatory support. The duration of CPB had a significant impact on the systemic lactate concentrations, V-A dpCO2 and the A-a O2 gradient, but not on the PLR. |
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Authors:
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Hrvoje Gasparovic; Stjepko Plestina; Zeljko Sutlic; Ino Husedzinovic; Vedran Coric; Visnja Ivancan; Ivan Jelic |
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Publication Detail:
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Type: Journal Article Date: 2007-09-29 |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 32 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-12 Completed Date: 2008-04-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 882-7 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, University Hospital Rebro Zagreb, Zagreb, Croatia. hgasparovic@kbc-zagreb.hr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carbon Dioxide / blood Cardiopulmonary Bypass* Coronary Artery Bypass* Female Humans Lactic Acid / blood, metabolism* Lung / metabolism* Male Middle Aged Oxygen / blood Partial Pressure Postoperative Period Prospective Studies Pulmonary Gas Exchange Respiration, Artificial |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 50-21-5/Lactic Acid; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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