Abstract PR224

Abstract

Background & Objectives: Serum lactate during ICU admission was used to predict outcome after adult and pediatric cardiac surgery [1]. This study was designed to study changes in serial serum lactate during and after pediatric cardiac surgery and to explore their relations to different perioperative variables. Materials & Methods: After obtaining local research ethical committee approval and informed parents’ consent, we studied forty children scheduled for cardiac surgery for repair congenital heart defects with cardiopulmonary bypass. Arterial serum lactate samples were taken after induction, during cooling, during rewarming, at end of cardiopulmonary bypass (CPB) and on intensive care (ICU) admission. Results: Mean (SD) age of patients was 73.47 (51.65) months, weight 21.92 (15.86) kg, and mean bypass and ischemic times were 91.72 (57.30), 61.90 (42.73) respectively. Serum lactate significantly increased during all studied periods compared to its level at induction. Peak level was during rewarming (Fig 1). Stepwise regression analysis showed that serum lactate during rewarming only dependent on CPB time (r2 = 0.272, P = 0.001) when age, ischemic time, bypass time, duration of mechanical ventilation, ICU stay and hospital stay were entered in the model. In addition, serum lactate on ICU admission was dependent on age (r2 = 0.351, P = 0.001) and hospital stay (r2 = 0.272, P = 0.001).Conclusion: Peak serum lactate occurred during rewarming is associated with CPB time, and lactate level on ICU admission is related to age and hospital stay.