Overview
This study aims to evaluate the relationship between intraoperative pulse pressure variation (PPV) and postoperative lactate clearance in adult patients undergoing elective cardiac surgery. Intraoperative PPV values will be recorded, and blood lactate levels will be measured at admission to the intensive care unit and at 6 and 12 hours postoperatively. The study will investigate whether intraoperative PPV is associated with postoperative lactate clearance. This is a prospective observational study, and no additional interventions will be performed beyond routine clinical care.
Description
This prospective observational cohort study will be conducted in adult patients aged 18-80 years undergoing elective coronary artery bypass graft surgery at Gaziantep University Hospital.
Intraoperative pulse pressure variation (PPV) will be recorded during surgery. Blood lactate levels will be measured at admission to the intensive care unit (0 hours) and at 6 and 12 hours postoperatively to assess lactate clearance.
The primary objective is to evaluate the relationship between intraoperative PPV and postoperative lactate clearance. The study will also explore the association between PPV and postoperative lactate clearance categories.
Patients with conditions that may affect the reliability of PPV measurements, including cardiac arrhythmias, spontaneous breathing, low tidal volume ventilation, and severe aortic regurgitation, will be excluded. Emergency surgeries and cases with missing essential hemodynamic or lactate data will also be excluded.
All measurements will be obtained as part of routine clinical care. No additional invasive procedures or study-specific interventions will be performed.
Eligibility
Inclusion Criteria:
- Adults aged 18-80 years.
- Patients undergoing elective coronary artery bypass graft (CABG) surgery.
- Patients receiving invasive arterial blood pressure monitoring and mechanical -ventilation during surgery.
- Patients planned for postoperative admission to the intensive care unit.
- Patients whose informed consent has been obtained.
Exclusion Criteria:
- Patients with cardiac arrhythmias that may interfere with PPV measurement, such as atrial fibrillation.
- Patients with severe aortic regurgitation.
- Patients undergoing emergency cardiac surgery.
- Patients receiving off-pump CABG.
- Patients requiring spontaneous breathing or low tidal volume ventilation (\<6 mL/kg) during PPV measurement.
- Patients with missing or insufficient intraoperative hemodynamic or postoperative lactate measurements.
