Hemodilution on Cardiopulmonary Bypass as a Determinant of Early Postoperative Hyperlactatemia |
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| Authors: | Marco Ranucci Giovanni Carboni Mauro Cotza Paolo Bianchi Umberto Di Dedda Tommaso Aloisio the Surgical and Clinical Outcome Research Group |
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| Institution: | Department of Cardiothoracic—Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, San Donato Milanese (Milan), Italy;Azienda Ospedaliero-Universitaria Careggi, ITALY |
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| Abstract: | ObjectiveThe nadir hematocrit (HCT) on cardiopulmonary bypass (CPB) is a recognized independent risk factor for major morbidity and mortality in cardiac surgery. The main interpretation is that low levels of HCT on CPB result in a poor oxygen delivery and dysoxia of end organs. Hyperlactatemia (HL) is a marker of dysoxic metabolism, and is associated with bad outcomes in cardiac surgery. This study explores the relationship between nadir HCT on CPB and early postoperative HL.DesignRetrospective study on 3,851 consecutive patients.ConclusionsHemodilution on CPB is an independent determinant of HL. This association, more evident for severe HL, strengthens the hypothesis that a poor oxygen delivery on CPB with consequent organ ischemia is the mechanism leading to hemodilution-associated bad outcomes. |
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