The Clinical Significance Of Dynamic Monitoring Arterial Blood Lactic Acid In Severe Patients During Perioperative Period Of Cardiac Surgery

Objective:To evaluate the clinical significance of dynamic monitoring arterial blood lactic acid in severe patients during perioperative period of cardiac surgery.Methods:75 cardiac surgery patients cases were divided into low-risk group, middle-risk group and high-risk group according to risk factors for cardiovascular surgery in Europe scoring system (EuroSCORE). quantity 31 cases, 22 cases, 22 cases respectively The blood lactate level were measured before the operation, 5 minutes after CPB, 15 minutes after aortic clamp, before the end of CPB, 2, 6, 12, 24,48hours after the operation. The aortic clamping time, cardiopulmonary bypass time, intensive care time, postoperative hospitalization time and total hospitalization time were also calculated at the same time.Results:The blood lactic acid values of three groups gradually went up with the anesthesia and surgery(P<0.05), reaching its peak 6 hours after operation, and then gradually went down. the arterial blood lactic acid of the low-risk group and the middle risk group came back to normal after operation in 24 hours (P>0.05) and 48 hours respectively, Compared to low-risk group and the middle-risk group, the arterial blood lactic acid value of high-risk group were significantly higher at the same time(P<0.01), and it did not come back to the normal in 48 hours.,even increased sometimes. The aortic clamping time and CPB time of high-risk group was much longer than those of the low-risk group and the middle-risk group (P< 0.01). In high-risk group, the arterial blood lactic acid value was much higher than that of the low-risk group and middle-risk group before the end of CPB(P <0.01). The elevated degree of blood lactic acid value was positively correlated with the aortic clamping time and CPB time. After surgical treatment, all patients in the three groups were cured. But the total hospitalization time ,postoperative hospitalization time and time in intensive care was significantly longer in the high-risk group than in low-risk group and middle-risk group. Conclusion:The dynamic monitoring of arterial blood lactic acid can be used as a significative index to guide doctors to know the internal environment of patients, determine the patients'condition and give reasonable treatments accordingly.