Does Central Venous Lactate Measurement ID Replace Arterial Lactate Measurement in Cardiac Surgery?

perfusion, are usually measured by blood gas analyzers simultaneously with blood gases. Although arterial blood is the “gold standard” for measurement of lactate, the interchangeable use of arterial and venous lactate measurements can avoid increased costs and iatrogenic anemia resulting from frequent blood sampling when evaluation of venous blood gas samples are preferred. In this study; we aimed to examine the correlation and agreement between the arterial lactate (AL) and central venous lactate (CVL) values in patients undergoing on-pump cardiac surgery. Method: Adult patients who had both arterial and central venous blood gas sampling simultaneously in three stages (T1: after anesthesia induction, T2: during cross- clamping, T3: during skin closure) of operation as part of anesthetic management were eligible for inclusion in this retrospective study. CVL and AL concentrations were estimated during blood gas analysis at stages T1, T2 and T3. Spearman Rho and Bland-Altman Tests were used to assess correlation and agreement between AL and CVL measurements, respectively. Results: Totally 366 pairs of blood samples were obtained from 122 eligible patients. The 95% limits of agreement were -0.07 to -0.00 at T1; 0.30 to -0.10 at T2 and -0.16 to -0.03 at T3. The 95% Cls were detected 0.86 to 0.93 (r=0.90 and p<0.0001) at T1;0.95 to 0.97 at T2 (r=0.96 and p<0.0001) and 0.92 to 0.96 (r=0.94 and p<0.0001) at T3. Conclusion: Although sampling from arterial lactate can be considered as the “gold standard” for lactate measurement, sampling from central venous blood is an acceptable alternative for lactate measurement in on-pump cardiac surgery patients. [ABSTRACT FROM AUTHOR]