Cardiothoracic & vascular anesthesia
The Predictive Value of Combined Lactate and Leukocyte Levels for Postoperative Morbidity after Prolonged Cardiopulmonary Bypass
Authors' conclusion
In the absence of technical surgical complications, a CPB duration ≥132 minutes signifies increased risk. For these patients, the simple product of immediate post-CPB lactate and leukocyte count is a powerful, readily available early predictor of a complicated postoperative course, potentially outperforming CPB duration alone and reflecting the combined pathophysiology of systemic inflammation and impaired perfusion.
Study context
- Population
- Adults undergoing elective cardiac surgery with cardiopulmonary bypass (CPB), without intraoperative technical surgical complications, urban teaching hospital
- Participants
- 150 adults
- Outcome
- Combined endpoint (unfavorable postoperative course): in-hospital mortality, prolonged mechanical ventilation >12 hours, RRT, neurologic complications (confusion, delirium, obtundation), norepinephrine >24 hours
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
CPB duration ≥132 minutes: specificity for the combined endpoint (ROC analysis)
93%
Lactate × Leukocytes ≥72 × 10⁹ × mmol × L-2 in prolonged CPB cohort (n = 35): AUC
0.909
Lactate × Leukocytes ≥72 × 10⁹ × mmol × L-2: sensitivity
100%
Lactate × Leukocytes ≥72 × 10⁹ × mmol × L-2: specificity
81%
Observational data: associations, not effects.
Further findings
Post-CPB leukocyte counts and lactate levels in prolonged CPB cohort · immediate post-CPB
- Significantly higher in patients who developed complications
Correlation of Lactate × Leukocytes with duration of postoperative mechanical ventilation
- Rho (p < 0.0001)
- 0.86
Original publication
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