Wang et al reported a nomogram for predicting postoperative hyperlactatemia following cardiac surgery. This can help to recognize a patient who may require more aggressive management. The authors are from multiple institutions in Wuhan, China.
Patient selection: status post elective cardiac surgery
Parameters:
(1) age in years, from 15 to 85
(2) renal insufficiency
(3) history of previous cardiac surgery
(4) left ventricular ejection fraction (LVEF) in percent, from 25 to 80 percent
(5) duration of cardiopulmonary bypass in minutes
(6) number of units of RBCs transfused during surgery
Parameter
Finding
Points
age in years
0.028 * (age)
renal insufficiency
no
0
yes
0.695
previous cardiac surgery
no
0
yes
1.125
LVEF
-0.050 * (percent)
cardiopulmonary bypass
0.013 * (minutes)
RBC transfusion
0.191 * (units)
value of X =
= SUM(points for all of the parameters) - 2.921
probability of hyperlactatemia =
= 1 / (1 + EXP((-1) * X))
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