Association Between Intraoperative Hyperlactatemia and Infection After Cardiac Surgery With Cardiopulmonary Bypass: A...

Area of Science:

• Cardiology
• Surgical Infection Prevention
• Critical Care Medicine

Background:

• Postoperative infections are a significant concern in cardiac surgery.
• Cardiopulmonary bypass (CPB) is associated with physiological changes that may impact infection risk.
• Intraoperative lactate levels are a potential marker for tissue hypoperfusion and adverse outcomes.

Purpose of the Study:

• To determine if intraoperative hyperlactatemia is an independent predictor of postoperative infection risk.
• To identify the threshold of intraoperative blood lactate levels associated with increased infection risk in cardiac surgery patients undergoing CPB.

Main Methods:

• A retrospective study of 4970 cardiac surgery patients who underwent CPB.
• Intraoperative hyperlactatemia defined as blood lactate > 2.0 mmol/L.
• Statistical analysis to assess the association between hyperlactatemia and postoperative infections, adjusting for confounders.

Main Results:

• Postoperative infection occurred in 14.49% of patients.
• Patients with infection had significantly higher intraoperative peak lactate levels (3.5 vs. 2.6 mmol/L).
• Intraoperative hyperlactatemia was independently associated with a 1.49-fold increased risk of postoperative infection (aOR: 1.49; 95% CI: 1.18-1.91).
• A peak lactate threshold of approximately 2.7 mmol/L was linked to higher infection risk.

Conclusions:

• Intraoperative hyperlactatemia is an independent risk factor for postoperative infection in cardiac surgery with CPB.
• Targeting intraoperative blood lactate levels below 2.7 mmol/L may be a strategy to reduce postoperative infection rates.