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. 2013 Oct 7;2(1):21.
doi: 10.1186/2047-0525-2-21.

Serum arterial lactate concentration predicts mortality and organ dysfunction following liver resection

Matthew G Wiggans #  1   2 , Tim Starkie #  3 , Golnaz Shahtahmassebi  4 , Tom Woolley  3 , David Birt  3 , Paul Erasmus  3 , Ian Anderson  3 , Matthew J Bowles  1 , Somaiah Aroori  1 , David A Stell  1   2
Affiliations

Serum arterial lactate concentration predicts mortality and organ dysfunction following liver resection

Matthew G Wiggans et al. Perioper Med (Lond). .

Abstract

Background: The aim of this study was to determine if the post-operative serum arterial lactate concentration is associated with mortality, length of hospital stay or complications following hepatic resection.

Methods: Serum lactate concentration was recorded at the end of liver resection in a consecutive series of 488 patients over a seven-year period. Liver function, coagulation and electrolyte tests were performed post-operatively. Renal dysfunction was defined as a creatinine rise of >1.5x the pre-operative value.

Results: The median lactate was 2.8 mmol/L (0.6 to 16 mmol/L) and was elevated (≥2 mmol/L) in 72% of patients. The lactate concentration was associated with peak post-operative bilirubin, prothrombin time, renal dysfunction, length of hospital stay and 90-day mortality (P < 0.001). The 90-day mortality in patients with a post-operative lactate ≥6 mmol/L was 28% compared to 0.7% in those with lactate ≤2 mmol/L. Pre-operative diabetes, number of segments resected, the surgeon's assessment of liver parenchyma, blood loss and transfusion were independently associated with lactate concentration.

Conclusions: Initial post-operative lactate concentration is a useful predictor of outcome following hepatic resection. Patients with normal post-operative lactate are unlikely to suffer significant hepatic or renal dysfunction and may not require intensive monitoring or critical care.

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Figures

Figure 1
Figure 1
Distribution of arterial lactate concentration in 488 patients at the end of liver resection.
Figure 2
Figure 2
Probability of renal dysfunction after liver resection according to lactate concentration in 484 patients.
Figure 3
Figure 3
Probability of 90-day mortality after liver resection according to lactate concentration in 488 patients.
See this image and copyright information in PMC

References

    1. Mann CD, Palser T, Briggs CD, Cameron I, Rees M, Buckles J, Berry DP. A review of factors predicting perioperative death and early outcome in hepatopancreaticobiliary cancer surgery. HPB. 2010;2:380–388. doi: 10.1111/j.1477-2574.2010.00179.x. - DOI - PMC - PubMed
    1. Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, Durand F. The “50-50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg. 2005;2:824–829. doi: 10.1097/01.sla.0000189131.90876.9e. - DOI - PMC - PubMed
    1. Schreckenbach T, Liese J, Bechstein WO, Moench C. Posthepatectomy liver failure. Dig Surg. 2012;2:79–85. doi: 10.1159/000335741. - DOI - PubMed
    1. Saner F. Kidney failure following liver resection. Transplant Proc. 2008;2:1221–1224. doi: 10.1016/j.transproceed.2008.03.068. - DOI - PubMed
    1. Savage AP, Malt MD. Elective and emergency hepatic resection determinants of operative mortality and morbidity. Ann Surg. 1991;2:689–695. doi: 10.1097/00000658-199112000-00008. - DOI - PMC - PubMed