{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:19Z","timestamp":1787022079492,"version":"build-2736575974"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"John Paul II Hospital, Krakow, Poland","award":["FN1\/2021"],"award-info":[{"award-number":["FN1\/2021"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Background<\/jats:title>\n \n It is unclear whether acid-base balance disturbances during the perioperative period may impact\n Clostridium difficile<\/jats:italic>\n infection (CDI), which is the third most common major infection following cardiac surgery. We hypothesized that perioperative acid-base abnormalities including lactate disturbances may predict the probability of incidence of CDI in patients after cardiac procedures.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Of the 12,235 analyzed patients following cardiac surgery, 143 (1.2%) developed CDI. The control group included 200 consecutive patients without diarrhea, who underwent cardiac procedure within the same period of observation. Pre-, intra and post-operative levels of blood gases, as well as lactate and glucose concentrations were determined. Postoperatively, arterial blood was drawn four times: immediately after surgery and successively; 4, 8 and 12 h following the procedure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Baseline pH was lower and PaO\n 2<\/jats:sub>\n was higher in CDI patients (\n p<\/jats:italic>\n < 0.001 and\n p<\/jats:italic>\n = 0.001, respectively). Additionally, these patients had greater base deficiency at each of the analyzed time points (\n p<\/jats:italic>\n < 0.001,\n p<\/jats:italic>\n = 0.004,\n p<\/jats:italic>\n = 0.012,\n p<\/jats:italic>\n = 0.001,\n p<\/jats:italic>\n = 0.016 and\n p<\/jats:italic>\n = 0.001, respectively). Severe hyperlactatemia was also more common in CDI patients; during the cardiac procedure, 4 h and 12 h after surgery (\n p<\/jats:italic>\n = 0.027,\n p<\/jats:italic>\n = 0.004 and\n p<\/jats:italic>\n = 0.001, respectively). Multivariate logistic regression analysis revealed that independent risk factors for CDI following cardiac surgery were as follows: intraoperative severe hyperlactatemia (OR 2.387, 95% CI 1.155\u20134.933,\n p<\/jats:italic>\n = 0.019), decreased lactate clearance between values immediately and 12 h after procedure (OR 0.996, 95% CI 0.994\u20130.999,\n p<\/jats:italic>\n = 0.013), increased age (OR 1.045, 95% CI 1.020\u20131.070,\n p<\/jats:italic>\n < 0.001), emergent surgery (OR 2.755, 95% CI 1.565\u20134.848,\n p<\/jats:italic>\n < 0.001) and use of antibiotics other than periprocedural prophylaxis (OR 2.778, 95% CI 1.690\u20134.565,\n p<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This study is the first to show that perioperative hyperlactatemia and decreased lactate clearance may be predictors for occurrence of CDI after cardiac surgery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0248512","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T13:42:59Z","timestamp":1615988579000},"page":"e0248512","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prognostic role of perioperative acid-base disturbances on the risk of Clostridioides difficile infection in patients undergoing cardiac 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