tailieunhanh - Báo cáo y học: "entral venous oxygen saturation and blood lactate levels during cardiopulmonary bypass are associated with outcome after pediatric cardiac surgery"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: entral venous oxygen saturation and blood lactate levels during cardiopulmonary bypass are associated with outcome after pediatric cardiac surgery. | Ranucci et al. Critical Care 2010 14 R149 http content 14 4 R149 c CRITICAL CARE RESEARCH Open Access Central venous oxygen saturation and blood lactate levels during cardiopulmonary bypass are associated with outcome after pediatric cardiac surgery 1 I 1 .z-I 1 1 1 2 Marco Ranucci Giuseppe Isgrò Concetta Carlucci Teresa De La Torre Stefania Enginoli Alessandro Frigiola Surgical and Clinical Outcome REsearch SCORE Group1 Abstract Introduction Central venous oxygen saturation and blood lactate are different indices of the adequacy of oxygen delivery to the oxygen needs. In pediatric cardiac surgery lactate level and kinetics during and after cardiopulmonary bypass are associated with outcome variables. The aim of this study was to explore the hypothesis that the lowest central venous oxygen saturation and the peak lactate value during cardiopulmonary bypass used alone or in combination may be predictive of major morbidity and mortality in pediatric cardiac surgery. Methods We conducted a retrospective analysis of 256 pediatric younger than 6 years patients who had undergone cardiac surgery with continuous monitoring of central venous oxygen saturation and serial measurement of blood lactate. Results Peak lactate was significantly increased when the nadir central venous oxygen saturation was 68 . Both nadir central venous oxygen saturation and peak lactate during cardiopulmonary bypass were independently associated with major morbidity and mortality with the same accuracy for major morbidity and a higher accuracy of peak lactate for mortality. A combined index central venous oxygen saturation 68 and peak lactate 3 mmol L provided the highest sensitivity and specificity for major morbidity with a positive predictive value of 89 . Conclusions The combination of a continuous monitoring of central venous oxygen saturation and serial measurements of blood lactate during cardiopulmonary bypass may offer a predictive index for major morbidity after cardiac .