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Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study
Thesis (MSc)--Stellenbosch University, 2020.
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| Format: | Thesis |
| Language: | en_ZA |
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2020
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| _version_ | 1867614045503225856 |
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| access_status_str | Open Access |
| author | Schoeman, Doreen |
| author2 | Smit, Marli |
| author_browse | Schoeman, Doreen Smit, Marli |
| author_facet | Smit, Marli Schoeman, Doreen |
| author_sort | Schoeman, Doreen |
| collection | Thesis |
| description | Thesis (MSc)--Stellenbosch University, 2020. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/109411 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:45:46.810Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/109411 Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study Schoeman, Doreen Smit, Marli Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Anesthesiology and Critical Care. Cardiopulmonary bypass Hyperlactataemia, Arterial lactate Lactates Thesis (MSc)--Stellenbosch University, 2020. ENGLISH ABSTRACT: Objective: To identify the incidence and the main contributing factor of postoperative hyperlactataemia following cardiopulmonary bypass surgery. Design: Single-centre, prospective, non-randomized, observational pilot study. Setting: Tertiary hospital, University setting. Participants: Twenty-six patients who all underwent cardiopulmonary bypass for elective cardiac surgery and who met the inclusion criteria. We excluded patients with pre-existing conditions or medications that could possibly alter lactate metabolism or contribute to aerobic increase in lactate production. Interventions: Observational. Measurements: Arterial lactate, mixed venous oxygen saturations (SvO2), haemoglobin, arterial saturation, and mixed venous partial pressure (PvO2) were measured. Delivery of oxygen (DO2) and oxygen consumption (V𝑂𝑂̇2) were calculated for the first twelve postoperative hours. Factors potentially influencing V𝑂𝑂̇ 2 (temperature, shivering, pain, anxiety, the use of inotropic support, and the presence or absence of ventilation) were also documented. Main results: Transient hyperlactataemia (that peaked between postoperative hours two to eight) occurred in 47% of cases following cardiopulmonary bypass. Postoperative hyperlactataemia occurred as a result of an increase in oxygen consumption (V𝑂𝑂̇ 2). The use of adrenaline and an increase in temperature (as a result of passive rewarming) were identified as the contributing factors responsible for this V 𝑂𝑂̇ 2 increase. Postoperative delivery of oxygen (DO2) remained adequate; as illustrated by normal to high cardiac output, haematocrit, and arterial saturations. AFRIKAANSE OPSOMMING: Objektief: Identifiseer die insidensie en hoof bydraende faktore tot verhoogde laktaat na kardiale chirurgie geassisteer deur ‘n kardiopulmonale pomp. Ontwerp: Enkel sentrum, prospektiewe, ewekansige, beskrywende studie. Omgewing: Tersiêre hospitaal, Universiteitsopset. Deelnemers: Ses en twintig pasiente vir elektiewe kardiale chirurgie wat aan die insluitings kriteria voldoen. Pasiente met ‘n onderliggende mediese toestand of medikasie wat die metabolisme van laktaat kan wysig of kan bydra tot ‘n aerobiese toename in laktaat produksie is uitgesluit. Intervensies: Geen, beskrywende studie Metings: Arteriële laktaat, gemeng veneuse saturasies (SvO2), hemoglobien, arteriële saturasie (SaO2) asook gemeng veneuse parsiële druk (PvO2) is gemeet. Suurstof lewering (DO2) en suurstof verbruik (V𝑂𝑂̇ 2) is bereken vir die eerste 12 uur na chirurgie. Faktore wat V𝑂𝑂̇ 2 kon beïnvloed (temperatuur, bewe, pyn, angs, die gebruik van inotropiese agente asook die teenwoordigheid of afwesigheid van ventilasie) is gedokumenteer. Resultate: ‘n Verbygaande hiperlaktatemie (met ‘n piek tussen die tweede en die agste uur postoperatief) was teenwoordig in 47% van gevalle. Die toename in hiperlaktatemie is die gevolg van ‘n toename in suurstof verbruik (V𝑂𝑂̇ 2). Die gebruik van adrenalien en ‘n toename in temperatuur (as gevolg van passiewe verwarming) is geïdentifiseer as die bydraende faktore vir die toename in V 𝑂𝑂̇ 2 . Die postoperatiewe lewering van suurstof (DO2) was deurgaans voldoende, soos geïllustreer deur normale tot verhoogde kardiale omset, hematokrit en arteriële suurstof saturasies. Gevolgtrekking: In hierdie studie was die hoë insidensie (47%) van postoperatiewe hiperlaktatemie die gevolg van ‘n toename in suurstof verbruik Stellenbosch University https://scholar.sun.ac.za 6 (V𝑂𝑂̇ 2). Die hoof bydraende faktor tot ‘n toename in suurstof verbruik (V𝑂𝑂̇ 2 ) was die gevolg van adrenalien via ‘n B2 gemedieërde effek. Masters 2020-06-29T08:15:46Z 2021-02-01T07:54:08Z 2020-06-29T08:15:46Z 2021-02-01T07:54:08Z 2020-06 Thesis http://hdl.handle.net/10019.1/109411 en_ZA 138 pages : illustrations application/pdf |
| spellingShingle | Cardiopulmonary bypass Hyperlactataemia, Arterial lactate Lactates Schoeman, Doreen Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study |
| title | Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study |
| title_full | Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study |
| title_fullStr | Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study |
| title_full_unstemmed | Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study |
| title_short | Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study |
| title_sort | lactate concentration and oxygen flux post cardiopulmonary bypass a pilot study |
| topic | Cardiopulmonary bypass Hyperlactataemia, Arterial lactate Lactates |
| url | http://hdl.handle.net/10019.1/109411 |
| work_keys_str_mv | AT schoemandoreen lactateconcentrationandoxygenfluxpostcardiopulmonarybypassapilotstudy |