Assessment of the Effect of Lactate on Patient Outcomes and Associated factors among Patients who Underwent Cardiopulmonary Bypass Surgery at Cardiac Center Ethiopia, Addis Ababa, Ethiopia 2021.
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Date
2021-02
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Addis Abeba University
Abstract
Introduction: Hyperlactatemia and lactic acidosis are commonly encountered during and after
cardiac surgery. Perioperative lactate production increases in the myocardium, skeletal muscle,
lungs and in the splanchnic circulation during cardiopulmonary bypass. Hyperlactatemia is
highly suggestive of tissue ischemia and is associated with a prolonged intensive care unit stay, a
prolonged requirement for respiratory and cardiovascular support and increased postoperative
mortality.
Objective: The objective of the study was to assess effect of lactate on patient outcomes and
associated factors among patients who underwent cardiopulmonary bypass surgery at Cardiac
Center Ethiopia, Addis Ababa, Ethiopia from December 2020 to February 2021.
Method: An institution-based retrospective cross-sectional study was done among all patients
who underwent cardiopulmonary bypass surgery from December to January. Data was collected
from patient chart review. The collected data was entered into Epidata version 4.2 and export to
SPSS 23 for analysis. Descriptive statistics for categorical and continuous variables was done. A
chi-square test was done to show the presence of an association between the outcome variable
and independent variables. A variables fitted on bivariate analysis was entered into multivariable
analysis to show the strength of association and statically significant variable.
Result: The prevalence of hyperlactatemia in this study among patients who underwent cardiac
surgery procedures at Cardiac Center Ethiopia was 37.5 %. Rise in lactate level prolongs ICU
stay, Prolongs intubation duration and increase need of Inotropes support. Lactate level was
measured on immediate postoperative day within 10 hours after the surgery and was defined as
lactate level > 3 mmol/L in the first hour after surgery. Age > 50 years [AOR: 6.8 (95% CI 1.725),
P=<0.008]. female gender [AOR: 1.8 (95% CI 1.1-3.8), P=0.048]. Variables statistically
significant were declared at 95 % CI, p-value < 0.05.
Conclusion and Recommended: Early rise in lactate level in patients who underwent
cardiopulmonary bypass surgery is a strong and robust predictor of morbidity and mortality.
Different patient and operative factors involved in this pathophysiology. As a result, strict follow
up management of those factors are recommended.
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Keywords
Hyperlactatemia, Associated factors, Adverse outcomes