Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study
| dc.contributor.advisor | Smit, Marli | en_ZA |
| dc.contributor.author | Schoeman, Doreen | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Anesthesiology and Critical Care. | en_ZA |
| dc.date.accessioned | 2020-06-29T08:15:46Z | en_ZA |
| dc.date.accessioned | 2021-02-01T07:54:08Z | en_ZA |
| dc.date.available | 2020-06-29T08:15:46Z | en_ZA |
| dc.date.available | 2021-02-01T07:54:08Z | en_ZA |
| dc.date.issued | 2020-06 | en_ZA |
| dc.description | Thesis (MSc)--Stellenbosch University, 2020. | en_ZA |
| dc.description.abstract | 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 (VššĢ2) were calculated for the first twelve postoperative hours. Factors potentially influencing VššĢ 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 (VššĢ 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 ššĢ 2 increase. Postoperative delivery of oxygen (DO2) remained adequate; as illustrated by normal to high cardiac output, haematocrit, and arterial saturations. | en_ZA |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Objektief: Identifiseer die insidensie en hoof bydraende faktore tot verhoogde laktaat na kardiale chirurgie geassisteer deur ān kardiopulmonale pomp. Ontwerp: Enkel sentrum, prospektiewe, ewekansige, beskrywende studie. Omgewing: TersiĆŖre hospitaal, Universiteitsopset. Deelnemers: Ses en twintig pasiente vir elektiewe kardiale chirurgie wat aan die insluitings kriteria voldoen. Pasiente met ān onderliggende mediese toestand of medikasie wat die metabolisme van laktaat kan wysig of kan bydra tot ān aerobiese toename in laktaat produksie is uitgesluit. Intervensies: Geen, beskrywende studie Metings: ArteriĆ«le laktaat, gemeng veneuse saturasies (SvO2), hemoglobien, arteriĆ«le saturasie (SaO2) asook gemeng veneuse parsiĆ«le druk (PvO2) is gemeet. Suurstof lewering (DO2) en suurstof verbruik (VššĢ 2) is bereken vir die eerste 12 uur na chirurgie. Faktore wat VššĢ 2 kon beĆÆnvloed (temperatuur, bewe, pyn, angs, die gebruik van inotropiese agente asook die teenwoordigheid of afwesigheid van ventilasie) is gedokumenteer. Resultate: ān Verbygaande hiperlaktatemie (met ān piek tussen die tweede en die agste uur postoperatief) was teenwoordig in 47% van gevalle. Die toename in hiperlaktatemie is die gevolg van ān toename in suurstof verbruik (VššĢ 2). Die gebruik van adrenalien en ān toename in temperatuur (as gevolg van passiewe verwarming) is geĆÆdentifiseer as die bydraende faktore vir die toename in V ššĢ 2 . Die postoperatiewe lewering van suurstof (DO2) was deurgaans voldoende, soos geĆÆllustreer deur normale tot verhoogde kardiale omset, hematokrit en arteriĆ«le suurstof saturasies. Gevolgtrekking: In hierdie studie was die hoĆ« insidensie (47%) van postoperatiewe hiperlaktatemie die gevolg van ān toename in suurstof verbruik Stellenbosch University https://scholar.sun.ac.za 6 (VššĢ 2). Die hoof bydraende faktor tot ān toename in suurstof verbruik (VššĢ 2 ) was die gevolg van adrenalien via ān B2 gemedieĆ«rde effek. | af_ZA |
| dc.description.version | Masters | en_ZA |
| dc.embargo.terms | 2023-12-31 | |
| dc.format.extent | 138 pages : illustrations | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/109411 | en_ZA |
| dc.language.iso | en_ZA | en_ZA |
| dc.subject.lcsh | Cardiopulmonary bypass | en_ZA |
| dc.subject.lcsh | Hyperlactataemia, | en_ZA |
| dc.subject.lcsh | Arterial lactate | en_ZA |
| dc.subject.lcsh | Lactates | en_ZA |
| dc.title | Lactate concentration and oxygen flux post cardiopulmonary bypass: a pilot study | en_ZA |
| dc.type | Thesis | en_ZA |