LACTACIDEMIA, PIRUVEMIA Y EXCESO DE LACTATO EN PACIENTES CON INFARTO AGUDO AL MIOCARDIO

Studies were made to elucidate the significance of lactate or pyruvate concentrations in blood, its ratio or the index called excess lactate, in the diagnosis of the severity of the cardiac failure in patients with acute myocardial infarction. Nine subjects with an average age of 64 yr, were studied during the first 24 to 48 hr after their admission to the intensive care coronary unit. Mean arterial pressure, cardiac output PaO ₂, PaCO ₂, arterial blood pH, arterial and venous blood lactate and pyruvate concentrations were measured. The group of patients was divided in two classes: class I, without clinical signs or with moderate cardiac failure, and class II with pulmonary edema or cardiogenic shock. Mean arterial pressure was higher than 90 mm. Hg. and cardiac index normal in class I patients; whereas, in those of class II these two values were lower than normal. The PaO ₂ values laid down the normal average in all patients, but no correlation was found with the severity of the cardiac failure. The PaCO ₂ values were lower than the normal mean in both groups. The arterial blood pH appeared slightly higher in class I. Lactate and pyruvate concentrations in arterial and venous blood were higher than normal in all patients; however, no correlation was observed with the severity of the cardiac failure. The highest concentrations were found in those patients who died. Lactate/pyruvate ratio was normal and no excess lactate was found in either case.