Superior cava vein saturation and cardiac lactate as cardiac output predictor after cardio-pulmonary bypass on children

Objective: to evaluate cardiac heart lactate, superior cava vein saturation and microcirculation dysfunction as cardiac output predictors after surgery on patients with Tetralogy of Fallot (TF) through measuring serum level of sTNFR-1 and IL-6. Design: cohort study Setting: Cipto Mangunkusumo Hospital Patient and participants: Subjects were children aged 1 to 6 years that underwent corrective surgery. Subjects who met the inclusion criteria were divided into 2 groups after is chemi are perfusion injury (post surgery). The first group was subjects with high cardiac lactate and the second group was subjects with low cardiac lactate. Measurements and results: Subjects were observed for 24 hours; during surgery, 6 and 24 hours after aortic clamp removed. During July 2012 - December 2013, there were 52 patients who became subjects. There were proportion differences between cardiac lactate and cardiac output change after cardiac surgery. Increase of cardiac lactate has a correlation with increasing levels of sTNFR-1 and IL-6 and decreasing index of Tc, ScvO2 and cardiac output. There were correlations among low index of ScvO2, high index of cardiac lactate and decrease of cardiac output. High sTNFR-1 and IL-6 were correlated to low cardiac output. Cardiac lactate, ScvO2 and MAP can be used as predictors of cardiac output change in patients with cardio-pulmonary bypass. sTNFR-1 and IL-6 levels were correlated with cardiac output changes after cardiac surgery. Conclusion: Cardiac lactate and ScvO2 are valuable in measuring cardiac output changes on patient with cardio-pulmonary bypass.