Cardiothoracic & vascular anesthesia
Anaerobic Lactate Production Is Associated With Decreased Microcirculatory Blood Flow and Decreased Mitochondrial Respiration Following Cardiovascular Surgery With Cardiopulmonary Bypass*
Authors' conclusion
Increased anaerobic lactate production, estimated by LPR, has a negative relationship with microcirculatory blood flow after cardiovascular surgery. This relationship does not persist when measuring lactate alone. In addition, decreased mitochondrial respiration is associated with increased lactate after cardiovascular surgery.
Study context
- Population
- Patients undergoing elective cardiovascular surgery with CPB, academic cardiovascular ICU
- Participants
- 132 patients
- Exposure
- High vs normal peak lactate in the first 6 hours after surgery
- Outcome
- Lactate-pyruvate ratio (LPR)
Methodological detailssingle-center
- Single-center
Main finding
As reported in the abstract
High lactate
14.4
± 2.5
Normal lactate
11.7
± 3.4
P = 0.005
Observational data: associations, not effects.
Further findings
Lactate-pyruvate ratio (LPR) vs microcirculatory flow index (linear regression)
- R
- −0.225
- β
- −0.037
- p
- P = 0.001
- Significant negative relationship
LPR vs proportion of perfused vessels (linear regression)
- R
- −0.17
- β
- −0.468
- p
- P = 0.009
- Significant negative relationship
Absolute plasma lactate vs microcirculation variables
- No significant relationship
Mitochondrial complex I and complex II oxidative phosphorylation
- Reduced in high vs normal lactate patients
- 22.6 ± 6.2 vs. 14.5 ± 7.4 pmol O 2 /s/10 6 cells; p = 0.002
Original publication
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