Lactate Clearance Predicts Good Neurological Outcomes in Cardiac Arrest Patients Treated with Extracorporeal Cardiopulmonary Resuscitation.
acute myocardial infarction
cardiac arrest
lactate clearance
neurological outcome
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
18 Mar 2019
18 Mar 2019
Historique:
received:
12
02
2019
revised:
09
03
2019
accepted:
11
03
2019
entrez:
21
3
2019
pubmed:
21
3
2019
medline:
21
3
2019
Statut:
epublish
Résumé
We evaluated critically ill patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) due to cardiac arrest (CA) with respect to baseline characteristics and laboratory assessments, including lactate and lactate clearance for prognostic relevance. The primary endpoint was 30-day mortality. The impact on 30-day mortality was assessed by uni- and multivariable Cox regression analyses. Neurological outcome assessed by Glasgow Outcome Scale (GOS) was pooled into two groups: scores of 1⁻3 (bad GOS score) and scores of 4⁻5 (good GOS score). A total of 93 patients were included in the study. Serum lactate concentration (hazard ratio (HR) 1.09; 95% confidence interval (CI) 1.04⁻1.13; Whereas lactate clearance does not predict mortality, it was the sole predictor of good neurological outcomes and might therefore guide clinicians when to stop ECPR.
Sections du résumé
BACKGROUND
BACKGROUND
We evaluated critically ill patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) due to cardiac arrest (CA) with respect to baseline characteristics and laboratory assessments, including lactate and lactate clearance for prognostic relevance.
METHODS
METHODS
The primary endpoint was 30-day mortality. The impact on 30-day mortality was assessed by uni- and multivariable Cox regression analyses. Neurological outcome assessed by Glasgow Outcome Scale (GOS) was pooled into two groups: scores of 1⁻3 (bad GOS score) and scores of 4⁻5 (good GOS score).
RESULTS
RESULTS
A total of 93 patients were included in the study. Serum lactate concentration (hazard ratio (HR) 1.09; 95% confidence interval (CI) 1.04⁻1.13;
CONCLUSIONS
CONCLUSIONS
Whereas lactate clearance does not predict mortality, it was the sole predictor of good neurological outcomes and might therefore guide clinicians when to stop ECPR.
Identifiants
pubmed: 30889788
pii: jcm8030374
doi: 10.3390/jcm8030374
pmc: PMC6462911
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Crit Care Med. 2004 Aug;32(8):1637-42
pubmed: 15286537
Am J Health Syst Pharm. 2007 Feb 1;64(3 Suppl 2):S14-21; quiz S28-30
pubmed: 17244882
Resuscitation. 2007 Nov;75(2):229-34
pubmed: 17583412
Lancet. 2008 Aug 16;372(9638):554-61
pubmed: 18603291
Lancet. 2008 Nov 29;372(9653):1879
pubmed: 19041796
Clin Hemorheol Microcirc. 2008;40(4):311-4
pubmed: 19126994
Crit Care. 2011;15(5):R242
pubmed: 22014216
Resuscitation. 2012 May;83(5):579-83
pubmed: 22056265
Resuscitation. 2012 Nov;83(11):1331-7
pubmed: 22819880
N Engl J Med. 2012 Nov 15;367(20):1912-20
pubmed: 23150959
Clin Res Cardiol. 2013 Sep;102(9):661-9
pubmed: 23657432
World J Crit Care Med. 2013 Nov 04;2(4):40-7
pubmed: 24701415
Am J Physiol Regul Integr Comp Physiol. 2014 Jul 1;307(1):R13-25
pubmed: 24760996
Resuscitation. 2014 Sep;85(9):1219-24
pubmed: 24992872
J Intensive Care Med. 2016 Jun;31(5):295-306
pubmed: 25693602
Clin Res Cardiol. 2015 Aug;104(8):679-87
pubmed: 25720332
Transfus Clin Biol. 2015 Aug;22(3):148-50
pubmed: 26070458
Clin Res Cardiol. 2016 Mar;105(3):196-205
pubmed: 26303097
Clin Hemorheol Microcirc. 2015;61(2):213-24
pubmed: 26410873
Circulation. 2015 Nov 3;132(18 Suppl 2):S315-67
pubmed: 26472989
Resuscitation. 2016 Apr;101:12-20
pubmed: 26836946
Crit Care. 2016 Jun 01;20(1):134
pubmed: 27245921
Emerg Med J. 2017 Feb;34(2):107-111
pubmed: 27357822
Heart Lung. 2016 Nov - Dec;45(6):532-537
pubmed: 27601212
Crit Care. 2016 Sep 29;20(1):306
pubmed: 27681259
Int J Cardiol. 2017 Mar 15;231:131-136
pubmed: 27986281
J Clin Med. 2018 Nov 20;7(11):null
pubmed: 30463365
Intensive Care Med. 2019 Jan;45(1):55-61
pubmed: 30478622
Intensive Care Med. 1997 Nov;23(11):1138-43
pubmed: 9434919