Effects of different vasoactive drugs on lactic acid level in adults undergoing corrective surgery for congenital heart disease under extracorporeal circulation
Qian Xiaoliang
Chen Yue
Yao Xiangyan
Dou Lidong
Abstract：Objective To evaluate the effects of different vasoactive drugs on lactic acid level in adults undergoing corrective surgery for congenital heart disease under extracorporeal circulation.Methods Forty patients who underwent corrective surgery for congenital heart disease under extracorporeal circulation at Huazhong Fuwai Hospital from January 2020 to December 2022 were selected as study subjects.According to different postoperative medication regimens,the patients were divided into adrenaline group and dopamine group,with 20 cases in each group.After extracorporeal circulation and rewarming,the patients in adrenal group received intravenous infusion of adrenaline injection at a dose of 0.03 μg·kg-1·min-1,while the patients in dopamine group received intravenous infusion of dopamine injection at a dose of 0.05 μg·kg-1·min-1.The dosage was maintained until the end of the surgery and safe return to monitoring room.The arterial occlusion time,extracorporeal circulation time,anesthesia time,postoperative extubation time,as well as blood gas analysis indicators and plasma lactic acid levels of two groups at different time points[before extracorporeal circulation transfer(T1),30 minutes after transfer(T2),rewarming(T3),opening ascending aorta(T4),stopping extracorporeal circulation for 10 minutes(T5),stopping extracorporeal circulation for 60 minutes(T6),1 hour after surgery(T7),3 hours after surgery(T8),6 hours after surgery(T9)and 9 hours after surgery(T10)]were compared.Results There were no statistically significant differences in arterial occlusion time,extracorporeal circulation time,anesthesia time and postoperative extubation time between adrenaline group and dopamine group[arterial occlusion time(minutes):35.2±12.3 vs.39.6±15.9;extracorporeal circulation time(minutes):67.5±23.4 vs.69.3±16.3;anesthesia time(hours):3.2±0.8 vs.3.5±0.3;postoperative extubation time(hours):6.5±0.6 vs.6.2±0.9;all P>0.05].The plasma lactic acid levels at time points T5,T6,T7,T8 and T9 in adrenaline group were higher than those in dopamine group,with statistically significant differences[T5(mmol/L):2.7±0.6 vs.1.7±0.7;T6(mmol/L):3.0±0.4 vs.1.8±0.8;T7(mmol/L):3.5±0.6 vs.2.0±0.4;T8(mmol/L):5.3±0.6 vs.1.7±0.4;T9(mmol/L):3.5±0.4 vs.1.4±0.2;all P<0.05].Conclusion Adrenaline,as a vasoactive adjuvant drug after cardiac surgery under extracorporeal circulation,is more likely to cause an increase in plasma lactic acid levels than dopamine,but it does not affect the prognosis of patients.
Keywords：Cardiac surgeryExtracorporeal circulationVasoactive drugDopamineAdrenalinePlasma lactic acid level
Publication Date：2024-12-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 319-323 )