成人心脏手术期间和术后乳酸升高:一项涉及病因、预后及管理的回顾性分析

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Lactate Elevation During and After Major Cardiac Surgery in Adults:A Review of Etiology,Prognostic Value, and Management.

背景与目的

乳酸升高在心脏手术术后很常见.

方  法

本综述总结了关于心脏手术期间和术后乳酸升高的复杂病因的文献,所考虑的因素包括:氧气输送,氧气利用,代谢增加,乳酸盐的清除,用药和补液以及术后并发症。其次,描述了乳酸与各种结局之间的关系,并对乳酸的预后作用进行了认真严格的评估。

结  果

尽管乳酸升高与许多重要结局密切相关,包括术后并发症,住院时间长和死亡率等,且我们对于术后乳酸升高的患者管理的最佳方案也是知之甚少。

结  论

此综述就是想通过对有限的文献进行评估分析以达到此目的。

原始文献摘要

Andersen LW.Lactate Elevation During and After Major Cardiac Surgery in Adults: A Review of Etiology,Prognostic Value, and Management.Anesth&Analg. 2017 Sep;125(3):743-752. doi: 10.1213/ANE.0000000000001928.

AbstractElevated lactate is a common occurrence after cardiac surgery. This review summarizes the literature on the complex etiology of lactate elevation during and after cardiac surgery, including considerations of oxygen delivery, oxygen utilization, increased metabolism, lactate clearance,medications and fluids, and postoperative complications. Second, the association between lactate and a variety of outcomes are described, and the prognostic role of lactate is Critically assessed. Despite the fact that elevated lactate is strongly associated with many important outcomes,including postoperative complications, length of stay, and mortality, little is known about the optimal management of postoperative patients with lactate elevations. This review ends with an assessment of the limited literature on this subject.

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