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Date Published: 29/09/2025
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DOI: https://doi.org/10.51298/vmj.v554i1.15574
Issue
Vol. 554 No. 1 (2025)
Section
Các bài báo
How to Cite
Hoàng, A. K., & Nguyễn, T. N. (2025). THE ROLE OF BLOOD LACTATE LEVELS AND LACTATE CLEARANCE IN PREDICTING POOR CLINICAL OUTCOMES AFTER CARDIOPULMONARY BYPASS CARDIAC SURGERY IN CHILDREN. Vietnam Medical Journal, 554(1). https://doi.org/10.51298/vmj.v554i1.15574

THE ROLE OF BLOOD LACTATE LEVELS AND LACTATE CLEARANCE IN PREDICTING POOR CLINICAL OUTCOMES AFTER CARDIOPULMONARY BYPASS CARDIAC SURGERY IN CHILDREN

Anh Khôi Hoàng, Thị Ngọc Nguyễn

Main Article Content

Abstract

Objective: To evaluate the role of blood lactate levels and lactate clearance during the first 24 hours after congenital heart surgery with cardiopulmonary bypass in children, in predicting poor clinical outcomes. Population and Study Design: This retrospective cohort study involved 98 pediatric patients from birth to 2 years of age who underwent cardiac surgery at the Ho Chi Minh City Heart Institute in 2021. Blood lactate levels were measured at five timepoints: T1 (ICU admission), T6, T12, T18, and T24. Lactate clearance was calculated as: (T1–Tx)/T1×100%. Primary outcomes included mortality, cardiac arrest, use of ECMO, seizures, and peritoneal dialysis. Secondary outcomes included prolonged mechanical ventilation and prolonged ICU stay. Results: A total of 98 eligible pediatric patients were included in the study. Nineteen children (19.4%) experienced adverse outcomes, including 3 deaths. Elevated blood lactate levels at all measured timepoints from T1 to T24 were significantly associated with poor clinical outcomes (p<0.001). Lactate clearance greater than 10% at T18 was associated with a reduced risk of adverse outcomes (p=0.028). Lactate clearance ≥10% at T6 and T12 was associated with a lower incidence of prolonged mechanical ventilation and ICU stay. Conclusion: Blood lactate concentration and lactate clearance are valuable prognostic indicators after cardiac surgery in young children, especially when monitored continuously during the first 24 hours postoperatively

Article Details

Keywords

congenital heart surgery, poor clinical outcome, hyperlactatemia, lactate clearance

References

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