Serum lactate changes and its correlation with serum liver tests in liver transplant patients

• Autor(a) principal: Machado, Mariana
• Data de Publicação: 2007
• Outros Autores: Marcelino, Paulo, Ferreira, Carlos, Marum, Susan, Marques-Vidal, Pedro, Fernandes, Ana Paula
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://revista.spmi.pt/index.php/rpmi/article/view/1554
• topic: transplante hepático; lactato sérico; Cuidados Intensivos; Liver transplant; Serum lactate; Intensive Care

Objective: To study the correlation between serum lactate levels and complications in the immediate post-operative phase of orthotopic liver transplant (OLT). Setting: medical-surgical intensive care unit with 14 bedsDesign: retrospective case-control studyMethods: 43 patients who underwent OLT were included in the study. Twenty-three patients had a favourable evolution and constituted the control group; 20 patients presented complications (9 of which were vascular) and were classified in 2 sub-groups based on serum liver parameters: hepatocellular (aminotransferase elevations) and cholestatic (serum elevation of gama-glutamyl transpeptidase and bilirubin). The following parameters were evaluated: age, gender, hospitalization and mechanical ventilation duration, APACHE II and SAPS II scores. The initial serum values of several biochemical parameters were registered and compared when an increase was found (1.5 - 2 times the prior value). Results: The patients with complications were predominantly female (p=0.047), presented longer hospitalization time (p<0.001) and had higher SAPS II scores (p<0.001). The initial lactate values were higher in the complicated group (9.4 versus 6.7 mmol/L, p=0.0046). Vascular complications correlated with a hepatocellular pattern. A 1.5 fold increase in lactate correlated with any complication and a 2-fold increase with hepatocellular complications. Using multivariate analysis, this variation in serum lactate was independently related to occurrence of any complication (CI 1.18-1.64, p=0.003).Conclusions: Complicated post-OLT patients presented a higher initial lactate value. Post-operative complications in the ICU correlated with 1.5-fold increase in serum lactate, while a 2-fold increase correlated with hepatocellular complications, especially those of vascular origin. Serum lactate may be a useful monitoring tool of complications in OLT patients in the ICU