Abstract

In this study, we wanted to identify the proportion of patients with high blood lactate levels during cardiopulmonary bypass (CPB) in coronary artery bypass grafting and its association with post-operative morbidity and mortality. We also wanted to determine the proportion of hyperlactatemia during CPB in patients undergoing CABG and assess the association between hyperlactatemia during CPB in patients undergoing CABG and post-operative morbidity and mortality. Methods: This was a hospital based single centre retrospective record study conducted among 130 patients who underwent coronary artery bypass surgery in the Department of Cardiovascular Thoracic Surgery, Government Medical College, Thiruvananthapuram, from January 2018 to January 2020 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. Results: Preoperatively females had higher lactate levels as compared to males, and this was statistically significant. The correlation between CPB time and peak intra-operative lactate level and also correlation between aortic cross-clamp time and peak lactate level was also found to be statistically significant. In post-operative morbidity, the length of ICU stays (<5 days - 32 [57.1%] vs. 57[76.5%]; ≥5 days - 24 [42.9%] vs. 17 [23.5%]; P = 0.013) were found to be significantly higher in the HL group. Conclusion: Hyperlactatemia during CPB in CABG points to perilous outcomes of cardiac surgery. It points to pathologies that need prompt correction to avert serious perioperative morbidity and mortality. It is an independent predictor of post-operative complications including all- cause mortality and severe morbidity after cardiac surgery in adult patients.

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