Intraoperative Lactate Trajectories and Clinical Outcomes in Pediatric Heart Transplantation:an Analysis Based on Group-Based Trajectory Modeling
SU Quanlin
QUAN Zilin
LI Tianbao
LIN Zhonglin
LEI Disi
LUO Zhichao
PENG Dong
WU Min
HUANG Jinsong
ZHOU Chengbin
Abstract：Objective To analyze the changes in intraoperative lactate levels in pediatric heart transplant patients and their impact on prognosis.Methods We retrospectively collected clinical data of pediatric heart transplant patients in the Department of Cardiac Surgery,Guangdong Provincial People's Hospital,from January 2018 to December 2023.Patients were divided into the survival group(n=39)and the death group(n=5)according to their status at discharge.Demographic characteristics,laboratory indicators,surgical parameters,and postoperative hospital stay were compared between the two groups.Repeated-measures ANOVA and group-based trajectory modeling(GBTM)were used to assess the effect of intraoperative lactate patterns on prognosis.Results A total of 44 children undergoing heart transplantation were included,of whom 5(11.36%)died after surgery and before discharge.Repeated measures ANOVA showed that lactate levels changed over time(F=10.424,P<0.001),with significant differences between groups(F=79.588,P<0.001),but the interaction between group and time was not statistically significant(F=1.354,P=0.234).GBTM identified two intraoperative lactate trajectories:high-level rapid increase and low-level slow increase.Patients with the low-level slow increase trajectory had a significantly lower risk of death than those with the high-level rapid increase trajectory,HR=0.588,P=0.034.Conclusion Pediatric heart transplant patients with a high-level rapid increase in intraoperative lactate had a worse prognosis.Early identification of high-risk lactate trajectories may help improve patient management and guide treatment strategies.
Keywords：pediatric heart transplantationintraoperativelactatetrajectory modelprognosis
Publication Date：2026-02-28
Online Publishing Date：2026-03-20(First online date of this platform, not the publication date of the document)
Pages：7( 1-7 )