Sažetak | Uvod: Izvantjelesni krvotok označava izmjenu plinova u krvi izvan tijela i održavanje protoka krvi unutar tijela pomoću mehaničke crpke. Hiperlaktatemija nakon operacije javlja se u značajnom broju kardiokirurških bolesnika.
----- Ciljevi rada: Ciljevi ovog istraživanja bili su ispitati povezanosti trajanja izvantjelesnog krvotoka, trajanja aortne kleme, dobi i spola s porastom vrijednosti laktata u poslijeoperacijskom razdoblju.
----- Materijal i metode: U ovoj retrospektivnoj presječnoj studiji bilo je uključeno 100 bolesnika koji su boravili na Odjelu za anesteziologiju i intenzivno liječenje kardiokirurških i vaskularnih bolesnika. 68 ih je bilo muškog spola, a 32 ženskog spola. Medijan dobi bolesnika bio je 64 god. (0-86). Prikupljeni su podaci o dobi, spolu, trajanju izvantjelesnog krvotoka, trajanju aortne kleme i vrijednostima laktata prije indukcije, neposredno po odvajanju od EKC-a te 6, 12 i 24 sata nakon prijema u JIL. Za statističku obradu podataka korišteni su programi Microsoft Excel 2013 i IBM SPSS Statistics.
----- Rezultati: Analizom podataka pronađene su tek slabe korelacije između dužine trajanja izvantjelesnog krvotoka i vrijednosti laktata nakon odvajanja od EKC-a (rS=0,382, p<0,001; rS=0,374, p<0,001; rS=0,427, p<0,001; rS=0,327, p=0,001). Ista slaba povezanost pronađena je i između trajanja aortlne kleme i vrijednosti laktata nakon odvajanja od EKC-a (rS=0,349, p<0,001; rS=0,325, p=0,001; rS=0,397, p<0,001; rS=0,326, p=0,002). Između dobi i vrijednosti laktata jedina statistički značajna korelacija bila je ona između dobi i vrijednosti laktata 12 sati nakon prijema u JIL (rs= 0,227, p = 0,023). U muških su bolesnika analizirane korelacije isto bile slabe, a u ženskih većina ih nije bila statistički značajna.
----- Zaključak: Trajanje izvantjelesnog krvotoka odnosno trajanje aortne kleme tek je slabo povezano s vrijednostima laktata nakon odvajanja od EKC-a. Dob i spol u naših bolesnika nisu utjecali na stvaranje laktata. |
Sažetak (engleski) | Introduction: Extracorporeal circulation (ECC) signifies extracorporeal blood gas exchange and maintenance of corporeal circulation with the help of a pump. Hyperlactatemia after cardiac surgery develops in a significant number of patients.
----- Aims: The aims of this study were to study the connection between extracorporeal circulation duration, aortic cross-clamping duration, age and sex and postoperative lactate level increase.
----- Materials and methods: This retrospective cross-sectional study included 100 patients who stayed in the Department of Anesthesiology and Intensive Care of Cardiac Surgery and Vascular Patients. 68 of them were male, and 32 were female. Median age was 64 years (0-86). The data was gathered on age, sex, extracorporeal circulation duration, aortic cross-clamping duration and lactate levels before the induction of anesthesia, immediately after weaning from ECC and 6, 12 and 24 hours after the admission to the intensive care unit (ICU). Microsoft Excel 2013 and IBM SPSS Statistics were used for the statistical analysis.
----- Results: Data analysis showed only weak correlations between extracorporeal circulation duration and lactate levels after weaning from ECC (rS=0,382, p<0,001; rS=0,374, p<0,001; rS=0,427, p<0,001; rS=0,327, p=0,001). The same weak correlations were found between aortic cross-clamping duration and lactate levels after weaning from ECC (rS=0,349, p<0,001; rS=0,325, p=0,001; rS=0,397, p<0,001; rS=0,326, p=0,002). Between age and lactate levels the only statistically significant correlation was found between age and lactate leves 12 hours after the admission to the ICU. In male patients weak correlation was also found, and in female patients the majority of correlations were not statistically significant.
----- Conclusion: The duration of extracorporeal circulation, that is, the aortic cross-clamping duration, is only weakly related to lactate levels after weaning from ECC. Age and sex did not affect lactate production in our patients. |