scholarly journals Blood lactate level as a predictor of patients’ outcome at the Respiratory Intensive Care Unit of Zagazig University Hospitals

2017 ◽  
Vol 11 (2) ◽  
pp. 128
Author(s):  
Waleed Mansour ◽  
RabieMohamed Hussein ◽  
HananMohamed El-Shahat ◽  
MoamenNabil Nada
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Lactate ◽  
Lactate Level ◽  
Blood Lactate Level ◽  
University Hospitals ◽  
Respiratory Intensive Care Unit

scholarly journals Evaluation of Blood Lactate Level as Predictor of Early Adverse Outcome after Cardiac Surgery under Cardiopulmonary Bypass

2019 ◽  
Vol 34 (1) ◽  
pp. 25-30 ◽  
Author(s):  
MAK Azad ◽  
KS Islam ◽  
MA Quasem
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Blood Lactate ◽  
Lactate Level ◽  
Adverse Outcome ◽  
Independent Predictor ◽  
Blood Lactate Level ◽  
Adult Cardiac Surgery

Background: We examined the hypothesis that high blood lactate level in intensive care unit patient after adult cardiac surgery under cardiopulmonary bypass is associated with early adverse outcome. The objective of this study was to evaluate whether high blood lactate level after cardiac surgery is a predictor of the early outcome after adult cardiac surgery under cardiopulmonary bypass. Methods: This prospective observational study was carried out in the department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka from July, 2013 to April 2014. A total number of 100 patients who underwent cardiac operation with cardiopulmonary bypass were enrolled in this study as per inclusion and exclusion criteria. Patients were divided into two groups according to their blood lactate level 6 hours after transferintensive care unit. Peroperative variables and postoperative variables were observed and recorded during the hospital course of patient. Categorical variables were analyzed by Chi- Square test and Fisher’s exact test and continuous variables were analyzed by ‘t’ test. Multiple Binary Logistic Regression Analysis of predictors for each of the outcome variables was done. Results: Blood lactate levels ≥3mmol/L 6 hours after transfer to intensive care unit were present in 57(57%) patients. Multiple logistic regression analysis showed higher blood lactate level was an independent predictor for early postoperative low output syndrome (OR 9.073, 95% CI 2.819 – 29.207, p = < .0001), pulmonary complication (OR 5.734, 95% CI 1.814 – 18.122, p = .003), neurological deficits (OR 9.725, 95% CI 1.111 - 85.147, p = .040), renal dysfunction (OR 7.393, 95% CI 1.855-29.469, p = .005), arrhythmia (OR 10.512, 95% CI 1.902 – 58.108, p = .007) and wound infection (OR 7.742, 95% CI 1.418 - 42.259, p = .018). Conclusions: High blood lactate level 6 hours after transfer to intensive care unit is an independent predictor for worse outcomes in adult patients after cardiac surgery under cardiopulmonary bypass. Bangladesh Heart Journal 2019; 34(1) : 25-30

scholarly journals Intraoperative changes in blood lactate levels are associated with worse short-term outcomes after cardiac surgery with cardiopulmonary bypass

Perfusion ◽  
2019 ◽  
Vol 34 (8) ◽  
pp. 640-650 ◽  
Author(s):  
Benoit Duval ◽  
Thibaud Besnard ◽  
Stefano Mion ◽  
Sébastien Leuillet ◽  
Olivier Jecker ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Blood Lactate ◽  
Lactate Level ◽  
Blood Lactate Level ◽  
Short Term ◽  
Laboratory Test Results ◽  
Lactate Levels ◽  
Blood Lactate Levels

Background: A high perioperative blood lactate level has been reported to be associated with poor outcomes after cardiac surgery. More than isolated peaks of lactate values, it should be more interesting to take into account changes in intraoperative blood lactate level (∆Lact). This large-scale retrospective study evaluated the relationship between ∆Lact and overall intensive care unit morbidity and 30-day all-cause mortality. Methods: Perioperative data from consecutive patients undergoing on-pump cardiac surgery between September 2010 and June 2016 were retrospectively analysed through our institutional database including clinical, transfusion and laboratory test results implemented prospectively by physicians. Blood lactate levels were initially measured after induction of anaesthesia (baseline) and periodically during the surgery. The ∆Lact was defined as the difference between the highest intraoperative blood lactate and the baseline lactate level and offered the opportunity to stratify patients into four subgroups: ⩽0, 0.1-0.9, 1-1.9 and ⩾2 mmol L−1. Results: From the 7,795 patients found eligible during the study period, 7,447 patients were analysed. The median ∆Lact of our patients was 0.6 (0.3-1) mmol L−1. Most of the studied patients (65.9%) exhibited a ∆Lact between 0.1 and 0.9 mmol L−1. A concentration-dependent relationship was observed between ∆Lact and intensive care unit morbidity and 30-day mortality. After adjustment for co-variables, all ∆Lact > 0 was associated with an increase in overall intensive care unit morbidity. An independent relationship was also found between ∆Lact and 30-day mortality as of a 1 mmol L−1 increase. Conclusion: Our results suggest that ∆Lact is associated with poor short-term outcomes in adult cardiac surgical patients.

scholarly journals More skilled clinical management of COVID-19 patients modified mortality in an intermediate respiratory intensive care unit in Italy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Giovanna E. Carpagnano ◽  
Giovanni Migliore ◽  
Salvatore Grasso ◽  
Vito Procacci ◽  
Emanuela Resta ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Clinical Management ◽  
Average Length ◽  
Limited Attention ◽  
Average Length Of Stay ◽  
Before And After ◽  
Respiratory Intensive Care Unit ◽  
Transferred Patients

Abstract Background Some studies investigated epidemiological and clinical features of laboratory-confirmed patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the virus causing coronavirus disease 2019 (COVID-19), but limited attention has been paid to the follow-up of hospitalized patients on the basis of clinical setting and the expertise of clinical management. Methods In the present single-centered, retrospective, observational study, we reported findings from 87 consecutive laboratory-confirmed COVID-19 patients with moderate-to-severe acute respiratory syndrome hospitalized in an intermediate Respiratory Intensive Care Unit (RICU), subdividing the patients in two groups according to the admission date (before and after March 29, 2020). Results With improved skills in the clinical management of COVID-19, we observed a significant lower mortality in the T2 group compared with the T1 group and a significantly difference in terms of mortality among the patients transferred in Intensive Care Unit (ICU) from our intermediate RICU (100% in T1 group vs. 33.3% in T2 group). The average length of stay in intermediate RICU of ICU-transferred patients who survived in T1 and T2 was significantly longer than those who died (who died 3.3 ± 2.8 days vs. who survived 6.4 ± 3.3 days). T Conclusions The present findings suggested that an intermediate level of hospital care may have the potential to modify survival in COVID-19 patients, particularly in the present phase of a more skilled clinical management of the pandemic.

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