The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 1 , Pages 170-173 , January 2010

Cardiopulmonary bypass flow rate: A risk factor for hyperlactatemia after surgical repair of secundum atrial septal defect in children

  • Boban P. Abraham, MD

      Affiliations

    • Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Parthak Prodhan, MBBS

      Affiliations

    • Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Section of Pediatric Cardiology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Robert D.B. Jaquiss, MD

      Affiliations

    • Section of Pediatric Cardiothoracic Surgery, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Adnan T. Bhutta, MD

      Affiliations

    • Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Section of Pediatric Cardiology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Jeffrey M. Gossett, MS

      Affiliations

    • Department of Biostatistics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Michiaki Imamura, MD, PhD

      Affiliations

    • Section of Pediatric Cardiothoracic Surgery, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Charles E. Johnson, RN, CCP

      Affiliations

    • Section of Pediatric Cardiothoracic Surgery, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Michael L. Schmitz, MD

      Affiliations

    • Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Section of Pediatric Cardiothoracic Surgery, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Section of Pediatric Cardiothoracic Anesthesia, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • William R. Morrow, MD

      Affiliations

    • Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Section of Pediatric Cardiology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • ,
  • Umesh Dyamenahalli, MD

      Affiliations

    • Department of Pediatrics, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Section of Pediatric Cardiology, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
    • Arkansas Children's Hospital, Little Rock, Ark
    • Corresponding Author InformationAddress for reprints: Umesh Dyamenahalli, MD, 1 Children's Way, 512-3, Little Rock, AR 72202.

Received 23 December 2008 ,Revised 2 April 2009 ,Accepted 22 April 2009.

References 

  1. Hamamoto M, Uemura H, Imanaka H, Yagihara T. Relevance of the measurement of the concentration of lactate in the serum subsequent to the Fontan procedure in small children. Cardiol Young. 2006;16:275–280
  2. Cheung PY, Chui N, Joffe AR, Rebeyka IM, Robertson CMT. and the Western Canadian Complex Pediatric Therapies Project, Follow-up Group. Postoperative lactate concentrations predict the outcome of infants aged 6 weeks or less after intracardiac surgery: a cohort follow-up to 18 months. J Thorac Cardiovasc Surg. 2005;130:837–843
  3. Munoz R, Laussen PC, Palacio G, Zienko L, Piercey G, Wessel DL. Changes in whole blood lactate levels during cardiopulmonary bypass for surgery for congenital cardiac disease: an early indicator of morbidity and Mortality. J Thorac Cardiovasc Surg. 2000;119:155–162
  4. Duke T, Butt W, South M, Karl TR. Early markers of major adverse events in children after cardiac operations. J Thorac Cardiovasc Surg. 1997;114:1042–1052
  5. Jenkins KJ, Newburger JW, Lock JE, Davis RB, Coffman GA, Iezzoni LI. In-hospital mortality for surgical repair of congenital heart defects: preliminary observations of variation by hospital caseload. Pediatrics. 1995;95:323–330
  6. Ranucci M, Toffol BD, Isgrò G, Romitti F, Conti D, Vicentini M. Hyperlactatemia during cardiopulmonary bypass: determinants and impact on postoperative outcome. Critical Care. 2006;10:R167
  7. Jonas RA, Wypij D, Roth SJ, Bellinger DC, Visconti KJ, du Plessis AJ, et al. The influence of hemodilution on outcome after hypothermic cardiopulmonary bypass: results of a randomized trial in infants. J Thorac Cardiovasc Surg. 2003;126:1765–1774
  8. Anttila V, Hagino I, Zurakowski D, Iwata Y, Duebener L, Lidov HGW, et al. Specific bypass conditions determine safe minimum flow rate. Ann Thorac Surg. 2005;80:1460–1467
  9. Chioléro RL, Revelly JP, Leverve X, Gersbach P, Cayeux MC, Berger MM, et al. Effects of cardiogenic shock on lactate and glucose metabolism after heart surgery. Crit Care Med. 2000;28:3784–3791
  10. Nilsson F, Ekroth R, Milocco I, Nilsson NJ, Svensson S, Berglin E, et al. Splanchnic glucose balance and insulin resistance in the early postoperative phase of cardiac surgery. J Parenter Enteral Nutr. 1988;12:574–578
  11. Visconti KJ, Bichell DP, Jonas RA, Newburger JW, Bellinger DC. Developmental outcome after surgical versus interventional closure of secundum atrial septal defect in children. Circulation. 1999;100;[suppl II]:II-145-50

PII: S0022-5223(09)01014-9

doi: 10.1016/j.jtcvs.2009.04.060

The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 1 , Pages 170-173 , January 2010

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