Related Experiment Video
Updated: Dec 27, 2025
Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
Frequency and Outcomes of Elevated Perioperative Lactate Levels in Adult Congenital Heart Disease Patients Undergoing
Jeffrey Kim1, Andrew Wu1, Tristan Grogan1
1Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Insights
Lactate levels did not predict outcomes like mortality or acute kidney injury in adult congenital heart disease patients after cardiac surgery. More research is needed to determine if lactate can be used for risk stratification in this population.
Area of Science:
- Cardiology
- Cardiac Surgery
- Critical Care Medicine
Background:
- Adult congenital heart disease (ACHD) patients represent a growing population undergoing cardiac surgery.
- Risk stratification for ACHD patients undergoing cardiac surgery is crucial for optimizing outcomes.
- Lactate levels are commonly used as a biomarker in critical care but their role in ACHD surgical outcomes is less defined.
Purpose of the Study:
- To investigate the association between peak arterial lactate levels and clinical outcomes in adult congenital heart disease patients following cardiac surgery.
- To determine if lactate levels can serve as a predictor of mortality, morbidity, and resource utilization in this specific patient cohort.
Main Methods:
- Retrospective study conducted at a single quaternary academic referral center.
- Included adult congenital heart disease patients (≥18 years) undergoing cardiac surgery with cardiopulmonary bypass.
- Patients were stratified into three groups based on peak arterial lactate levels within 48 hours post-surgery.
Main Results:
- No significant differences were observed in acute kidney injury, hospital or ICU length of stay, mechanical ventilation duration, or 30-day readmission rates among lactate level groups.
- Multivariable analysis, accounting for bypass time, redo surgery, case electivity, and ACHD complexity score, showed lactate levels were not significant predictors of acute kidney injury or hospital length of stay.
- In-hospital 30-day mortality, need for redo surgery, and ICU readmission rates also did not significantly differ across lactate groups.
Conclusions:
- While lactate levels hold theoretical potential for risk stratification in ACHD surgical patients, current evidence is insufficient to support their use as a predictor of mortality or morbidity.
- Further investigation is warranted to establish the utility of lactate monitoring in guiding clinical decisions and predicting outcomes in this complex patient population.
Objectives:
To assess whether lactate levels are associated with clinical outcomes in adult congenital heart disease patients who undergo cardiac surgery.
Design:
Retrospective study.
Setting:
Single quaternary academic referral center.
Participants:
Adult congenital heart disease patients (≥18 y old) with congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass.
Interventions:
Participants were classified into 3 groups according to their peak arterial lactate level within the first 48 hours of surgery.
Measurements And Main Results:
In-hospital 30-day mortality, hospital and intensive care unit length of stay, duration of mechanical ventilation after surgery, acute kidney injury defined by Acute Kidney Injury Network criteria, and intensive care unit and hospital readmission within 30 days of surgery were examined. There was no significant difference among different lactate level groups in acute kidney injury, hospital length of stay, intensive care unit length of stay, hours of mechanical ventilation, need for redo surgery, or rates of hospital or intensive care unit readmission. In multivariable analysis, which included cardiopulmonary bypass time, redo surgery, nonelective case, and the adult congenital heart disease complexity score, lactate levels were not a significant predictor of either acute kidney injury or hospital length of stay.
Conclusions:
The appeal of using lactate levels to risk stratify-patients or to develop a model to predict mortality and morbidity has potential merit, but currently there is insufficient evidence to use lactate levels as a predictor of outcomes in adult patients with congenital heart disease undergoing cardiac surgery.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:29Cardiomyopathy V: Interprofessional Care