Hyperlactatemia after heart transplantat tied to greater risk of mortality and veno-arterial ECMO initiation: Study
Hyperlactatemia (HL) is a prevalent complication following cardiac surgery. It is related to tissue hypoperfusion and hypoxia. The condition is tied to poor clinical outcomes.According to a study published in the Journal of Cardiology, Severe hyperlactatemia following orthotopic heart transplant was linked to a higher likelihood of VA ECMO initiation and mortality at 30...
Hyperlactatemia (HL) is a prevalent complication following cardiac surgery. It is related to tissue hypoperfusion and hypoxia. The condition is tied to poor clinical outcomes.
Although HL is often observed following orthotopic heart transplantation (OHTx), the relationship between the two pertaining to outcomes is unclear. The study investigated the occurrence and consequences of HL in patients following OHTx.
- Patients with higher postoperative peak lactate levels were more commonly transplanted from left ventricular assist device support (33.3 % vs 50.9 % vs 64.9). They had longer cardiopulmonary bypass time (127 min vs 141 min vs 153 min)
- 8.6 % of patients (n=18) met the Composite primary endpoint. It was more common in patients with higher postoperative peak lactate levels (0.0 % vs 6.4 % vs 19.3 %).
- Postoperative hyperlactatemia (HL) >5 mmol/L was seen in 79.9% of patients after OHTx.
- Early postoperative HL was tied to a greater risk of mortality and or use of VA ECMO.
- The threshold value was high, around 10 mmol/L. the sensitivity and specificity were 61.1% and 75.9%, respectively.
- There was a 32 % increase in the risk of the primary outcome for each unit increase in lactate with OR 1.32
- CPB time and preoperative durable LVAD were associated with postoperative severe HL.
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