Impact of Lactate Clearance on Clinical and Neurological Outcomes of Patients With Out-of-Hospital Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation : A Secondary Data Analysis
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc..
OBJECTIVES: Serial evaluations of lactate concentration may be more useful in predicting outcomes in patients with out-of-hospital cardiac arrest (OHCA) than a single measurement. This study aimed to evaluate the impact of lactate clearance (LC) on clinical and neurologic outcomes in patients with OHCA who underwent extracorporeal cardiopulmonary resuscitation (ECPR).
DESIGN: Retrospective multicenter observational study.
SETTING: Patients with OHCA receiving ECPR at 36 hospitals in Japan between January 1, 2013, and December 31, 2018.
PATIENTS: This study evaluated 1227 patients, with lactateinitial assessed upon emergency department admission and lactatesecond measured subsequently. To adjust for the disparity in the time between lactate measurements, the modified 6-hour LC was defined as follows: ([lactateinitial-lactatesecond]/lactateinitial) × 100 × (6/the duration between the initial and second measurements [hr]). The patients were divided into four groups according to the modified 6-hour LC with an equivalent number of patients among LC quartiles: Q1 (LC < 18.8), Q2 (18.8 < LC < 59.9), Q3 (60.0 < LC < 101.2), and Q4 (101.2 < LC).
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: The 30-day survival rates increased as the 6-hour LC increased (Q1, 21.2%; Q2, 36.8%; Q3, 41.4%; Q4, 53.6%; p for trend < 0.001). In the multivariate analysis, the modified 6-hour LC was significantly associated with a 30-day survival rate (adjusted odds ratio [AOR], 1.003; 95% CI, 1.001-1.005; p < 0.001) and favorable neurologic outcome (AOR, 1.002; 95% CI, 1.000-1.004; p = 0.027).
CONCLUSIONS: In patients with OHCA who underwent ECPR, an increase in the modified 6-hour LC was associated with favorable clinical and neurologic outcome. Thus, LC can be a criterion to assess whether ECPR should be continued.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Critical care medicine - (2024) vom: 27. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sugimoto, Momoko [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Revised 27.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1097/CCM.0000000000006245 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369014057 |
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| 041 | |a eng | ||
| 100 | 1 | |a Sugimoto, Momoko |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of Lactate Clearance on Clinical and Neurological Outcomes of Patients With Out-of-Hospital Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation |b A Secondary Data Analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Revised 27.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. | ||
| 520 | |a OBJECTIVES: Serial evaluations of lactate concentration may be more useful in predicting outcomes in patients with out-of-hospital cardiac arrest (OHCA) than a single measurement. This study aimed to evaluate the impact of lactate clearance (LC) on clinical and neurologic outcomes in patients with OHCA who underwent extracorporeal cardiopulmonary resuscitation (ECPR) | ||
| 520 | |a DESIGN: Retrospective multicenter observational study | ||
| 520 | |a SETTING: Patients with OHCA receiving ECPR at 36 hospitals in Japan between January 1, 2013, and December 31, 2018 | ||
| 520 | |a PATIENTS: This study evaluated 1227 patients, with lactateinitial assessed upon emergency department admission and lactatesecond measured subsequently. To adjust for the disparity in the time between lactate measurements, the modified 6-hour LC was defined as follows: ([lactateinitial-lactatesecond]/lactateinitial) × 100 × (6/the duration between the initial and second measurements [hr]). The patients were divided into four groups according to the modified 6-hour LC with an equivalent number of patients among LC quartiles: Q1 (LC < 18.8), Q2 (18.8 < LC < 59.9), Q3 (60.0 < LC < 101.2), and Q4 (101.2 < LC) | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: The 30-day survival rates increased as the 6-hour LC increased (Q1, 21.2%; Q2, 36.8%; Q3, 41.4%; Q4, 53.6%; p for trend < 0.001). In the multivariate analysis, the modified 6-hour LC was significantly associated with a 30-day survival rate (adjusted odds ratio [AOR], 1.003; 95% CI, 1.001-1.005; p < 0.001) and favorable neurologic outcome (AOR, 1.002; 95% CI, 1.000-1.004; p = 0.027) | ||
| 520 | |a CONCLUSIONS: In patients with OHCA who underwent ECPR, an increase in the modified 6-hour LC was associated with favorable clinical and neurologic outcome. Thus, LC can be a criterion to assess whether ECPR should be continued | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Takayama, Wataru |e verfasserin |4 aut | |
| 700 | 1 | |a Inoue, Akihiko |e verfasserin |4 aut | |
| 700 | 1 | |a Hifumi, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Sakamoto, Tetsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Kuroda, Yasuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Otomo, Yasuhiro |e verfasserin |4 aut | |
| 700 | 0 | |a Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J II) study group |e verfasserin |4 aut | |
| 700 | 1 | |a Senda, Asae |e investigator |4 oth | |
| 700 | 1 | |a Suzuki, Hajime |e investigator |4 oth | |
| 700 | 1 | |a Tanimoto, Atsunori |e investigator |4 oth | |
| 700 | 1 | |a Kitagawa, Kanta |e investigator |4 oth | |
| 700 | 1 | |a Katayama, Yoichi |e investigator |4 oth | |
| 700 | 1 | |a Igarashi, Nobuaki |e investigator |4 oth | |
| 700 | 1 | |a Kawano, Masayuki |e investigator |4 oth | |
| 700 | 1 | |a Kuroki, Yuji |e investigator |4 oth | |
| 700 | 1 | |a Umehara, Tadashi |e investigator |4 oth | |
| 700 | 1 | |a Sasaki, Yukari |e investigator |4 oth | |
| 700 | 1 | |a Tominaga, Naoki |e investigator |4 oth | |
| 700 | 1 | |a Hamaguchi, Takuro |e investigator |4 oth | |
| 700 | 1 | |a Sakai, Takuma |e investigator |4 oth | |
| 700 | 1 | |a Abe, Takeru |e investigator |4 oth | |
| 700 | 1 | |a Hanafusa, Hiroaki |e investigator |4 oth | |
| 700 | 1 | |a Yamaoka, Yuki |e investigator |4 oth | |
| 700 | 1 | |a Kakizaki, Yumi |e investigator |4 oth | |
| 700 | 1 | |a Sakato, Shinya |e investigator |4 oth | |
| 700 | 1 | |a Kashiwabara, Shiho |e investigator |4 oth | |
| 700 | 1 | |a Kadoya, Takashi |e investigator |4 oth | |
| 700 | 1 | |a Misumi, Kayo |e investigator |4 oth | |
| 700 | 1 | |a Kobayashi, Takaomi |e investigator |4 oth | |
| 700 | 1 | |a Yamada, Sou |e investigator |4 oth | |
| 700 | 1 | |a Kobayashi, Masakazu |e investigator |4 oth | |
| 700 | 1 | |a Akashi, Naoko |e investigator |4 oth | |
| 700 | 1 | |a Kuno, Masamune |e investigator |4 oth | |
| 700 | 1 | |a Maruyama, Jun |e investigator |4 oth | |
| 700 | 1 | |a Kobata, Hitoshi |e investigator |4 oth | |
| 700 | 1 | |a Soh, Mitsuhito |e investigator |4 oth | |
| 700 | 1 | |a Shirasaki, Kasumi |e investigator |4 oth | |
| 700 | 1 | |a Shiba, Daiki |e investigator |4 oth | |
| 700 | 1 | |a Isokawa, Shutaro |e investigator |4 oth | |
| 700 | 1 | |a Uchida, Masatoshi |e investigator |4 oth | |
| 700 | 1 | |a Sakurai, Atsushi |e investigator |4 oth | |
| 700 | 1 | |a Tatsukawa, Hirotaka |e investigator |4 oth | |
| 700 | 1 | |a Nishikawa, Marie |e investigator |4 oth | |
| 700 | 1 | |a Kojima, Mitsuaki |e investigator |4 oth | |
| 700 | 1 | |a Kosaki, Ryohei |e investigator |4 oth | |
| 700 | 1 | |a Shimazui, Takashi |e investigator |4 oth | |
| 700 | 1 | |a Kinoshita, Hiroki |e investigator |4 oth | |
| 700 | 1 | |a Sawada, Yusuke |e investigator |4 oth | |
| 700 | 1 | |a Yamamoto, Ryo |e investigator |4 oth | |
| 700 | 1 | |a Masuzawa, Yuya |e investigator |4 oth | |
| 700 | 1 | |a Matsumura, Kazuki |e investigator |4 oth | |
| 700 | 1 | |a Shimazaki, Junya |e investigator |4 oth | |
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