Lactate and base excess as predictors of mortality in patients with Tetralogy of Fallot
10.3760/cma.j.issn.1001-4497.2018.07.003
- VernacularTitle:乳酸与碱剩余评估法洛四联症患儿预后的价值研究
- Author:
Han ZHANG
1
;
Gang LI
;
Yao-Qiang XU
;
Xiangming FAN
;
Junwu SU
;
Yinglong LIU
Author Information
1. 100029,首都医科大学附属北京安贞医院小儿心脏中心
- Keywords:
Lactate;
Base excess;
Tetralogy of Fallot;
Prognosis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2018;34(7):394-397
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the distribution of lactate and base excess in children with Tetralogy of Fallot in perio-perative period, its dynamic variation and its relationship with prognosis.Methods Perioperative arterial lactate level was dy-namically monitored in 1 552 children with tetralogy of Fallot.According to the prognosis, 1 505 subjects were assigned to sur-vive group, and 47 subjects to nonsurvive group.The lactate and base excess levels of all subjects were collected after induction (T1), after protamine administration(T2), and 24 h(T3) after surgery in the intensive care unit(ICU).Results The pa-tients who could not survive showed significant elevated lactate levels as compared to patients who survived after surgery [(7.91 ±5.76)mmol/L vs.(1.20 ±0.51)mmol/L, P＜0.05].However, in nonsurvivors, the BE value decreased signifi-cantly in the ICU period in comparison to survivors[(－1.91 ±5.09)mmol/L vs.(2.52 ±2.85)mmol/L, P＜0.05].Logis-tic regression analysis was performed, indicating the elevated lactate and depressed base excess levels measured 24 h after sur-gery were independent risk factors.Conclusion The dynamic monitoring of lactate and base excess levels in the perioperative period in patients with tetralogy of Fallot were sensitive indicators to assess severity , to guide treatments, and for the prognosis. In the perioperative period, when the lactate increased and(or) base excess levels decreased, the mortality rate increased as well.lactate and base excess levels measured 24 h after surgery in the ICU were independent risk factors that significantly in-creased the mortality rate.
