Abstract
Aim: To evaluate the correlation of blood lactate and mixed venous oxygen saturation to predict outcome in off-pump coronary artery bypass grafting. Method: This is a randomized study including 30 patients. Blood lactate and mixed venous oxygen saturation were measured in 4 groups of patients—number of grafts, presence or absence of left main coronary artery disease, ejection fraction and serum creatinine. Blood samples were taken before induction, after grafting, on intensive care unit admission, 24 hours and 48 hours after surgery. The measured blood lactate and mixed venous oxygen saturation are compared to assess the outcomes in terms of duration of ventilation and intensive care unit stay. Results: The blood lactate and mixed venous oxygen saturation values increased post operatively but no statistically significant difference in three groups— number of grafts, left main coronary artery disease and ejection fraction. In serum creatinine group, the blood lactate value was found to be statistically significant after grafting in patients with creatinine <1.5 mg/dl, however, there was a significant disparity in numbers. Conclusion: Mixed venous oxygen saturation is a better predictor of morbidity than blood lactate in terms of intensive care unit stay in patients undergoing off pump coronary artery bypass grafting.
Highlights
Coronary artery disease is surgically treated by grafting the coronary arteries with different native vessels
The blood lactate level was highest in the sample sent on day one in patients with left main disease (2.281 mmol/L) and was highest on intensive care unit admission in patients without left main disease (2.742 mmol/L) and decreased thereafter
Factors independently associated with hyperlactatemia were the preoperative serum creatinine value, active endocarditis, duration of cardiopulmonary bypass, ionotropes and the peak blood glucose level [8]
Summary
Coronary artery disease is surgically treated by grafting the coronary arteries with different native vessels. Coronary artery bypass grafting was traditionally performed by using cardiopulmonary bypass. (2014) Correlation of Blood Lactate and Mixed Venous Oxygen Saturation in Off-Pump CABG. The avoidance of cardiopulmonary bypass has been proposed to reduce the postoperative systemic inflammatory response in off-pump coronary artery bypass grafting (OPCAB). Blood lactate and mixed venous oxygen saturation are different indices of adequacy of oxygen delivery to the tissues. Studies have shown that high blood lactate levels and low mixed venous oxygen saturation during coronary artery bypass grafting are potential early predictors of morbidity and mortality [1] [2]
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