Ácido láctico y asociación con la mortalidad en el posoperatorio de cirugía cardiaca. Estudio cohorte retrospectiva

Abstract

ObjectiveTo analyse the behaviour of lactic acid in the first 24h after surgery in cardiac surgery, and conditions associated with its elevation and impact on clinical evolution as a factor associated with mortality. DesignObservational, analytical, retrospective cohort study, repeated measures. Scope4-Level clinical cardiovascular intensive care unit in Colombia. ParticipantsPatients over 18 years of age who were admitted to the intensive care unit in the postoperative period of cardiac surgery with the need for extracorporeal circulation. InterventionsMeasurement of lactic acid 0, 6, 12, 18 and 24h after surgery. Variable of interestLactic acid, mediastinal bleeding, extracorporeal circulation time, aortic clamp time, overall in-hospital mortality. ResultsA total of 214 people were included, the most frequent surgery was aortic change (43.9%), hypertension was present in 48.6% of the patients, the overall in-hospital mortality was 5.6%, the time of average hospital stay in ICU 3 days, during follow-up lactic acid was higher in those who died, with the greatest difference at 12h, with the variables that influence the change in lactic acid were aortic clamp time, mediastinal bleeding >1000cc, urea nitrogen and the use of two inotropes, the factors that increase the risk of mortality were lactic acid greater than 3mmol/l RR 13.96 CI 1.55–125.9; p-value=.019, and mediastinal bleeding >1000cc, RR: 2.55 (CI: 1.00-6.51), p-value=.049. ConclusionLactic acid was shown to be an associated factor for mortality at different times of monitoring, always higher in the people who died.