Lactate release during reperfusion predicts low cardiac output syndrome after coronary bypass surgery Vivek Rao, MD, PhD, Joan Ivanov, RN, MSc, Richard.

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Presentation transcript:

Lactate release during reperfusion predicts low cardiac output syndrome after coronary bypass surgery Vivek Rao, MD, PhD, Joan Ivanov, RN, MSc, Richard D Weisel, MD, Gideon Cohen, MD, Michael A Borger, MD, Donald A.G Mickle, MD The Annals of Thoracic Surgery Volume 71, Issue 6, Pages 1925-1930 (June 2001) DOI: 10.1016/S0003-4975(01)02634-0

Fig 1 The relationship between myocardial lactate release, oxygen extraction, and acid release during reperfusion and the development of postoperative low output syndrome (LOS). Patients in whom LOS developed had significantly higher lactate release immediately after aortic cross-clamp removal (XCL OFF) and at 5 minutes of reperfusion (5′). However, net myocardial lactate release at 10 minutes of reperfusion (10′) was not different between groups. There were no differences in myocardial oxygen extraction or acid release at any time point. The Annals of Thoracic Surgery 2001 71, 1925-1930DOI: (10.1016/S0003-4975(01)02634-0)

Fig 2 (A) The relationship between myocardial lactate release at 5 minutes of reperfusion and the development of postoperative low output syndrome (LOS). Arbitrary cut-points (POS = positive; NEG = negative) reveal an increased prevalence of LOS in those patients who released more than 0.4, 0.6 or 0.8 mmol/L of lactate. (B) A receiver operating characteristics (ROC) curve was constructed from the arbitrary cut-points used in panel A. The optimal balance between sensitivity and specificity for predicting postoperative LOS is determined at a cut-point of 0.4 mmol/L of lactate (the point closest to the upper left quadrant). The area under the ROC curve, which estimates the precision of the diagnostic test, is 0.6328. The Annals of Thoracic Surgery 2001 71, 1925-1930DOI: (10.1016/S0003-4975(01)02634-0)