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[Intraoperative lactic acidosis, can it be treated? Clinico-experimental, prospective, sequential study]
P Pietropaoli1, S Caporelli, F De Pace
1Istituto delle Emergenze Medico-Chirurgiche, Università degli Studi, Ancona.
Minerva Anestesiologica
|December 1, 1994
Summary
Alkaline solutions neutralize acidosis but do not significantly reduce lactic acid levels. L-carnitine showed no metabolic benefit in patients undergoing vascular surgery.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Biochemistry
Background:
- Lactic acidosis is a common complication in major vascular surgery.
- Alkaline therapy and L-carnitine are potential treatments.
- Their efficacy in improving lactate levels during surgery is debated.
Purpose of the Study:
- To evaluate the effectiveness and safety of alkaline solutions for lactic acidosis.
- To assess the role of L-carnitine in lactate metabolism during surgery.
- To compare these interventions against saline solution.
Main Methods:
- Prospective study of 65 patients undergoing major vascular surgery.
- Three groups: alkaline therapy, L-carnitine, or saline control.
- Measurements included heart rate, blood pressure, blood gases, and lactic acid levels.
Main Results:
- Alkaline therapy showed a neutralizing effect on acidosis.
- No significant differences in lactic acid levels were observed between groups.
- L-carnitine did not demonstrate any metabolic stimulation under the study conditions.
Conclusions:
- Alkaline therapy is well-tolerated but its clinical usefulness in reducing lactic acid is not clearly demonstrated.
- L-carnitine did not prove effective in improving lactate metabolism in this surgical setting.
- Further research may be needed to clarify the role of these interventions.