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Metabolic disturbances, such as changes in blood acid-base balance and electrolytic composition; hyperglycemia and hyperlactatemia, are frequent factors that complicate the early postoperative period in patients after cardiac surgery under extracorporeal circulation. The purpose of the study was to estimate the incidence of hyperlactatemia in the early postoperative period and to reveal the predictors of its occurrence. This prospective study was conducted in our center from November 14, 2006, to September 1, 2007. The study covered 270 patients above 15 years of age, who had been operated on for coronary heart disease, acquired heart diseases, and combined lesions of valves and coronary arteries. Hyperlactatemia was observed in a substantial proportion of patients who had been operated on under extracorporeal circulation. Correlation analysis indicated a significant association between the duration of extracorporeal circulation and the magnitude of hyperlactatemia developing in the early postoperative period. Hyperglycemia with a glucose level of > 9 mmol/l is a predictor of the development of hyperglycemia.

Aim: To study diagnostic and prognostic significance of lactate in cerebrospinal fluid (CSF) and blood in patients with bacterial purulent meningitis (BPM) of different etiology., Material and Methods: BPM and blood lactate levels were studied in 112 patients aged 18-70 years by the enzyme assay on the biochemical analyzer Hitachi 902 at admission to hospital, on the treatment days 3-7, 8-18., Results: BPM is associated with marked lactate-acidosis in CSF and moderate one in the blood. The lactate level in the blood was higher in patients with generalized infection in moderate enhancement of lactate-acidosis in CSF. Changes in CSF lactate concentration depends on the etiological factor, efficacy of antibacterial therapy, course and outcome of the disease. Direct correlation was found of CSF lactate level with that of protein level and cytosis in CSF, a negative correlation--with glucose concentration., Conclusion: The test for lactate concentration in the blood and CSF and their correlation (CSF/blood coefficient) is effective in differential diagnosis between BPM, serous viral meningitis, non-inflammatory lesions of CNS, for assessment of treatment efficacy, prognosis of the disease outcome.