Cardiovascular Perfusion and Nursing 2022 , Vol 1, Issue 2
Is there a difference in serum lactate level between conventional and minimal extracorporeal circulation systems?
Türkan Okyay1,Halil Türkoğlu2
1Sağlık Bilimleri Üniversitesi Ahi Evren Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Perfüzyon, Trabzon, Türkiye
2Medipol Mega Üniversite Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
DOI : 10.5606/e-cvpn.2022.190 Objectives: This study aims to evaluate the effect on tissue perfusion by comparing serum lactate levels in conventional and minimal extracorporeal circulation systems in coronary artery bypass graft operations.

Patients and methods: Forty consecutive patients (32 males, 8 females; mean age: 65.0±10.5 year; range, 42 to 85 year) who underwent isolated coronary artery bypass graft between November 2017 and November 2018 were included in this retrospective cross sectional study. The patients were divided into two groups: the conventional group (Group 1, n=20) and the mini-circuit group (Group 2, n=20).

Results: The mean activated clotting time was 440.8±33.4 sec in Group 1 and 286.4±38.2 sec in Group 2 (p <0.001). The mean volume of drainage was 800 mL in Group 1 (range, 300 to 2000 mL), whereas in Group 2, it was 450 mL (range, 300 to 1000 mL). According to the groups, the amount of drainage was found to be significantly different in the traditional group, almost twice the MECC group. (p<0.001). The median serum lactate level of the conventional group was higher than the mini-circuit group on postoperative 0th and 3rd days (p=0.043 ve p=0.023, respectively).

Conclusion: The use of the mini-circuit system in the extracorporeal circulation reduces the serum lactate level more than the conventional system, yielding better tissue perfusion. The minimal extracorporeal circulation system is a safe alternative perfusion method for risky patients. Keywords : Cardiopulmonary bypass, centrifugal pumps, coronary artery bypass, extracorporeal circulation, L-lactate dehydrogenase