The correlation of peroperative serum lactate and cereatinine levels with postoperative results in congenital open heart surgeries

The physiology of children is different from that of adolescents. Especially the rate of the growth of their organs and their immunity?s being less strong than that of adolescents have pointed to the fact that their diseases and treatments should be examined separately. The systems, drugs, and electrolytes used during cardiopulmonary bypass bring about changes in the metabolism and organ functions at cellular level, causing changes in normal physiology as well. Child patients response to these changes taking place in the course of open heart surgery grows even more severe in relation to the side effects of cardiopulmonary bypass and difficulties in the adaptation of the surgery being performed. Invasive monitorisation, cardiac monitorisation and fluid balance follow-ups are used in intensive care follow-ups of the patients. In the aftermath of congenital patients operations, it is hard to determine a reliable indicator for morbidity and mortality. We aim to find the changes during cardiopulmonary bypass and to be able to correctly pre-evaluate the post-operative morbidity and mortality of congenital heart patientsIn this study, we took arterial blood samples from 30 congenital heart patients with a history of cardiopulmonary bypass at the preoperative phase (Episode 1: after the anesthesia has been applied), at the fifth minute of the cooling phase of cardiopulmonary bypass (Episode 2), at the fifth minute of the heating phase of cardiopulmonary bypass (Episode 3) and at the sixth hour during post-operative intensive (Episode 4), and increased the correlationbetween lactate and creatinine levels of these samples. 26 patients discharged uneventfully after the study-based surgery were admitted as Group I, and 4 patients who developed exitus due to multiorgan insufficiency resulting from low heart rate during the 7.5, 9, 13, 18. minutes of the intensive care were admitted as Group II. It was observed that the lactate values in Group I increased during cardiopulmonary bypass (Episode I, Episode II) and decreased during intensive care. However, we found salient differences between lactate and creatinine values in Groups I and II. The increase in lactate values stems from oxygen shortage caused by tissue perfusion impair and anaerobic metabolism at cellular level. The increase in creatinine, on the other hand, is the result of the tissue perfusion impair at a later phase leading to dysfunction in the kidneysKEY WORDS: Lactate, Creatinine, Congenital Heart Disease, Mortality, Morbidity