Correlation between Post-operative Serum Lactate Levels and Low Cardiac Output Syndrome in Patients Undergoing Coronary Artery Bypass Grafting Surgery: A Prospective Study in a Tertiary Care Hospital

Authors

  • Muhammad Farhan Khan Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan
  • Adnan Ali Khahro Shaheed Mohatrama Benazir Bhutto Medical College, Layari Karachi
  • Iqbal Hussain Pathan Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan
  • Naveed Nek Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan
  • Hosh Muhammad Bughio Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan
  • Mudassir Iqbal Dar Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan

DOI:

https://doi.org/10.47144/phj.v57i1.2623

Abstract

Objectives: This study aimed to assess the correlation between the development of low cardiac output syndrome (LCOS) and post-operative serum lactate levels in patients undergoing coronary artery bypass grafting (CABG) surgery at a tertiary care hospital.

Methodology: A prospective cross-sectional study was conducted from January to June 2021, involving 50 patients undergoing CABG surgery with cardiopulmonary bypass. Arterial samples were obtained immediately post-surgery and at six, twelve, and twenty-four-hour intervals post-operatively. The association between lactate levels and the occurrence of LCOS, need for inotropic support, and intra-aortic balloon pump (IABP) utilization was evaluated.

Results: The study comprised predominantly male patients (84%). Patients were categorized into two groups based on lactate levels: Group 1 (> 4 mmol/L) and Group 2 (< 4 mmol/L). In Group 1, 32% of patients developed LCOS, 10% required IABP, and 20% needed inotropic and vasopressor support. Immediately post-CABG, the mean lactate level was 7.5 mmol/L, with 3% requiring IABP and 20% needing double inotropic support. Lactate levels decreased over time, with mean levels at six, twelve, and twenty-four hours post-surgery being 6.3 mmol/L, 3.8 mmol/L, and 3.3 mmol/L, respectively. Correspondingly, the need for IABP and inotropic support decreased. LCOS occurrence within 24 hours post-surgery correlated significantly with elevated lactate levels (p < 0.05).

Conclusion: Elevated lactate levels were associated with the development of LCOS within 24 hours post-CABG surgery. Monitoring lactate levels postoperatively may serve as a valuable tool in predicting and managing LCOS in CABG patients.

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Author Biographies

Muhammad Farhan Khan, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan

Assistan professor

cardiac surgery

Adnan Ali Khahro, Shaheed Mohatrama Benazir Bhutto Medical College, Layari Karachi

senior registrar

Cardiac Surgery

Iqbal Hussain Pathan, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan

Associate Professor

Cardiac Surgery

Naveed Nek, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan

Assistant Professor

Cardiac surgery

Hosh Muhammad Bughio, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan

Registrar

Cardiac Surgery

Mudassir Iqbal Dar, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Khairpur Mirs, Sindh, Pakistan

Professor 

Cardiac Surgery

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Published

2024-03-30

How to Cite

1.
Khan MF, Khahro AA, Pathan IH, Nek N, Bughio HM, Dar MI. Correlation between Post-operative Serum Lactate Levels and Low Cardiac Output Syndrome in Patients Undergoing Coronary Artery Bypass Grafting Surgery: A Prospective Study in a Tertiary Care Hospital. Pak Heart J [Internet]. 2024Mar.30 [cited 2024Jun.16];57(1):9-12. Available from: https://pakheartjournal.com/index.php/pk/article/view/2623

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Original Article