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Gerami, Hamid, Sajedianfard, Javad, Ghasemzadeh, Bahram, AnsariLari, Maryam. (1403). Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass. سامانه مدیریت نشریات علمی, 49(9), 550-558. doi: 10.30476/ijms.2023.99730.3186
Hamid Gerami; Javad Sajedianfard; Bahram Ghasemzadeh; Maryam AnsariLari. "Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass". سامانه مدیریت نشریات علمی, 49, 9, 1403, 550-558. doi: 10.30476/ijms.2023.99730.3186
Gerami, Hamid, Sajedianfard, Javad, Ghasemzadeh, Bahram, AnsariLari, Maryam. (1403). 'Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass', سامانه مدیریت نشریات علمی, 49(9), pp. 550-558. doi: 10.30476/ijms.2023.99730.3186
Gerami, Hamid, Sajedianfard, Javad, Ghasemzadeh, Bahram, AnsariLari, Maryam. Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass. سامانه مدیریت نشریات علمی, 1403; 49(9): 550-558. doi: 10.30476/ijms.2023.99730.3186

Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass

Iranian Journal of Medical Sciences
مقاله 2، دوره 49، شماره 9، آذر 2024، صفحه 550-558    اصل مقاله (800.26 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/ijms.2023.99730.3186
نویسندگان
Hamid Gerami1؛ Javad Sajedianfard* 1؛ Bahram Ghasemzadeh2؛ Maryam AnsariLari3
1Department of Basic Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
2Department of Cardiac Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
3Department of Food Hygiene and Public Health, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
چکیده
Background: Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) is utilized to minimize hemodilution. However, removing high volumes leads to tissue hypoperfusion by activating the anaerobic glycolysis pathways.  This study aimed to determine the association between weight-indexed CUF volumes and lactate in patients who underwent coronary artery bypass grafting (CABG).
Methods: In this single-center retrospective study, 641 CABG patients, who were referred to Al-Zahra Hospital (Shiraz, Iran) and underwent CPB, during 2019-2021, were recruited. Peri-operative parameters were extracted from the patient’s records. The patients with non-elective status, pre-existing liver and renal diseases, ejection fraction<35%, and repeated sternotomy were excluded from the study. An increase in post-operative lactate level≥4 mmol/L after 6 hours was defined as hyperlactatemia (HL). To predict HL, univariable and multiple logistic regression modeling, while controlling confounding factors, were employed.
Results: The patients’ mean age was 58.8±11.1 years, and 39.2% were women. The incidence of HL was 14.5% (93 patients). There was a significant association between weight-indexed CUF volume and HL. The volume removed in the HL patients was almost doubled (43.37±11.32 vs. 21.41±8.15 mL/Kg, P<0.001), and the higher the weight-indexed CUF volume, the more likely to develop an HL at a rate of 1.38 (Odds ratio=1.38 [1.27-1.49], 95% CI, P<0.001). Furthermore, the multiple logistic regression model showed that HL was associated with the lowest mean arterial pressure (MAP) during CPB.
Conclusion: A higher volume of ultrafiltration was associated with increased post-operative serum lactate levels. 
کلیدواژه‌ها
Cardiopulmonary bypass؛ Ultrafiltration؛ Hemofiltration؛ Hyperlactatemia؛ Lactic acid
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مراجع
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