e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Effect of cardiopulmonary bypass on late-onset hyperlactatemia after pediatric cardiac surgery
Behzat Tüzün1, Servet Ergün1, Şerife Özalp2, Mehmet Akif Önalan1, Berra Zümrüt Tan Recep1, Eymen Recep1, İbrahim Cansaran Tanıdır3, Erkut Öztürk3, Ali Can Hatemi1
1Department of Pediatric Cardiovascular Surgery, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
2Department of Anesthesiology and Reanimation, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
3Department of Pediatric Cardiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2025.26627
Background: This study aimed to investigate the effect of operative and postoperative parameters on late-onset hyperlactatemia (LOHL) after cardiac surgery in the pediatric patient population.

Methods: One hundred fifty-nine ventricular septal defect patients (77 males, 82 females; mean age: 8.0±8.6 years; range, 1 to 48 years) were retrospectively examined between August 2020 and February 2023. Patients with the highest lactate value measured between 6 to 12 h postoperatively <3 mmol/L were defined as Group 1, and those with lactate values ≥3 mmol/L (LOHL) were included in Group 2.

Results: Cardiopulmonary bypass (CPB) time, aortic cross-clamp time, and CPB flow did not differ between groups (p=0.916, p=0.729, and p=0.699, respectively). The difference between partial oxygen pressure (PaO2) in the first blood gas obtained after CPB was statistically significant (p=0.017). The lactate level measured in the first arterial blood gas obtained after CPB was 1.74±0.61 mmol/L in Group 1 and 3.01±1.63 mmol/L in Group 2 (p<0.001). The PaO2 in the arterial blood gas measured at 6 h postoperatively was 129.22±61.20 mmHg in Group 1 and 156.07±64.49 mmHg in Group 2 (p=0.046).

Conclusion: The development of hyperlactatemia due to ischemia in the early post-CPB period may affect the development of LOHL. Microcirculatory changes at the tissue level may play a role in the etiology of LOHL.

Keywords : Late onset hyperlactatemia, pediatric cardiac surgery, ventricular septal defect
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