A case of unexplained lactic acidosis during cardiopulmonary bypass in the long term hemodialysis patient underwent mitral valve replacement

Abstract

　Postoperative elevation of blood lactate levels are associated with increased morbidity and length of stay following a cardiopulmonary bypass (CPB). The causes of hyperlactatemia are various and the reasons not fully understood. In this case of long term hemodialysis, the cause of hyperlactatemia after CPB was unknown during the patient underwent mitral valve replacement. Continuous hemodiafiltration and percutaneous cardiopulmonary support could not save the patient. The major cause of hyperlactatemia was considered to be multiple organ failure due to peripheral circulatory failure or sepsis. Future investigations were needed to establish the data for adequate pressure and flow during CPB in patients of long term hemodialysis.