The impact of hyperlactatemia on postoperative outcome after adult cardiac surgery

Alexander Kogan*, Leonid Sternik, Dan Spiegelstein, Sergey Preisman, Jacob Lavee, Alex Bar, Ateret Malachy, Haim Berkenstadt, Ehud Raanani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose To evaluate the value of blood lactate value in predicting postoperative mortality (primary outcome), duration of ventilation, and length of stay in an intensive care unit (ICU) and hospital (secondary outcomes). Methods We performed a prospective observation study on 1,820 consecutive patients undergoing open heart surgery in a tertiary university medical center. Blood lactate levels were obtained from patients on admission to the cardiac surgical ICU and measured serially. Results All patients were divided into three groups according to their maximum blood lactate levels: group I (normolactatemia, lactate ≤2.2 mmol/l), 332 patients; group II (mild hyperlactatemia, lactate 2.2-4.1 mmol/l), 1,054 patients; and group III (severe hyperlactatemia, lactate ≥4.4 mmol/l), 434 patients. Maximum blood lactate levels ≥4.4 mmol/l during the first 10 h post admission were associated with prolonged ventilation time, longer ICU stay, and increased mortality (P <0.001). Conclusions Hyperlactatemia is common after cardiac surgery. Maximal lactate threshold ≥4.4 mmol/l in the first 10 h after operation accurately predicts postoperative mortality.

Original languageEnglish
Pages (from-to)174-178
Number of pages5
JournalJournal of Anesthesia
Issue number2
StatePublished - Apr 2012


  • Cardiac anesthesia
  • Lactate
  • Postoperative care


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