Serum lactate in refractory out-of-hospital cardiac arrest: Post-hoc analysis of the Prague OHCA study
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F23%3A10472573" target="_blank" >RIV/00064165:_____/23:10472573 - isvavai.cz</a>
Alternative codes found
RIV/68407700:21730/23:00367832 RIV/00216208:11110/23:10472573
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Ih5~Wgb7UG" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=Ih5~Wgb7UG</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.resuscitation.2023.109935" target="_blank" >10.1016/j.resuscitation.2023.109935</a>
Alternative languages
Result language
angličtina
Original language name
Serum lactate in refractory out-of-hospital cardiac arrest: Post-hoc analysis of the Prague OHCA study
Original language description
Background: The severity of tissue hypoxia is routinely assessed by serum lactate. We aimed to determine whether early lactate levels predict outcomes in refractory out-of-hospital cardiac arrest (OHCA) treated by conventional and extracorporeal cardiopulmonary resuscitation (ECPR).Methods: This study is a post-hoc analysis of a randomized Prague OHCA study (NCT01511666) assessing serum lactate levels in refractory OHCA treated by ECPR (the ECPR group) or conventional resuscitation with prehospital achieved return of spontaneous circulation (the ROSC group). Lactate concentrations measured on admission and every 4 hours (h) during the first 24 h were used to determine their relationship with the neurological outcome (the best Cerebral Performance Category score within 180 days post-cardiac arrest).Results: In the ECPR group (92 patients, median age 58.5 years, 83% male) 26% attained a favorable neurological outcome. In the ROSC group (82 patients, median age 55 years, 83% male) 59% achieved a favorable neurological outcome. In ECPR patients lactate concentrations could dis-criminate favorable outcome patients, but not consistently in the ROSC group. On admission, serum lactate >14.0 mmol/L for ECPR (specificity 87.5%, sensitivity 54.4%) and >10.8 mmol/L for the ROSC group (specificity 83%, sensitivity 41.2%) predicted an unfavorable outcome.Conclusion: In refractory OHCA serum lactate concentrations measured anytime during the first 24 h after admission to the hospital were found to correlate with the outcome in patients treated by ECPR but not in patients with prehospital ROSC. A single lactate measurement is not enough for a reliable outcome prediction and cannot be used alone to guide treatment.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30223 - Anaesthesiology
Result continuities
Project
—
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Resuscitation
ISSN
0300-9572
e-ISSN
1873-1570
Volume of the periodical
192
Issue of the periodical within the volume
November
Country of publishing house
IE - IRELAND
Number of pages
8
Pages from-to
109935
UT code for WoS article
001109141900001
EID of the result in the Scopus database
2-s2.0-85169507829