LACTATE ON INTENSIVE CARE UNIT ADMISSION AS A PROGNOSTIC MARKER AFTER CARDIAC SURGICAL INTERVENTIONS WITH EXTRACORPOREAL CIRCULATION

Abstract

Objective: To correlate serum lactate values on admission to the Intensive Care Unit with the main complications and outcomes of patients' clinical conditions in the postoperative period, seeking to establish the metabolite as a biomarker for the outcome of these cases based on comparisons between the data observed in the research. Methods: Exploratory quantitative study, carried out retrospectively, through the analysis of medical records of patients admitted to the Intensive Care Unit of a teaching hospital in Western Paraná after cardiac procedures using extracorporeal circulation. The records cover the period between September 2022 and November 2023. Results: Among the 144 medical records analyzed, 38.09% of patients showed an increase in lactic acid levels at the time of admission to the ICU. Of this percentage, 67.21% were greater than or equal to sixty (60) years of age. Combined cardiac surgeries showed a higher rate of hyperlactatemia, since the mean cardiopulmonary bypass was higher in patients with this metabolite. Severity scores (APACHE II and SAPS III) were higher when in a situation of hyperlactatemia. Furthermore, 66.66% of patients with higher lactate required hemodialysis and 53.12% had intraoperative atrial fibrillation. The preoperative comorbidity analyzed was Chronic Obstructive Pulmonary Disease, present in 27.27% of patients with increased lactate. Furthermore, patients with hyperlactatemia had prolonged exposure to invasive mechanical ventilation and hospitalization in the ICU. Finally, 60% of deaths occurred in patients with lactate levels greater than 3mmol/L.Conclusion: The results present lactate as a good predictor of the outcome of patients undergoing cardiac surgery, being elevated in individuals who presented greater complications and unfavorable outcomes.