• Je něco špatně v tomto záznamu ?

Serum lactate in refractory out-of-hospital cardiac arrest: Post-hoc analysis of the Prague OHCA study

M. Dusik, D. Rob, J. Smalcova, S. Havranek, J. Karasek, O. Smid, HL. Brodska, P. Kavalkova, M. Huptych, J. Bakker, J. Belohlavek

. 2023 ; 192 (-) : 109935. [pub] 20230811

Jazyk angličtina Země Irsko

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc24000887

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 discriminate 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.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc24000887
003      
CZ-PrNML
005      
20240213093438.0
007      
ta
008      
240109e20230811ie f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.resuscitation.2023.109935 $2 doi
035    __
$a (PubMed)37574002
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a ie
100    1_
$a Dusik, Milan $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
245    10
$a Serum lactate in refractory out-of-hospital cardiac arrest: Post-hoc analysis of the Prague OHCA study / $c M. Dusik, D. Rob, J. Smalcova, S. Havranek, J. Karasek, O. Smid, HL. Brodska, P. Kavalkova, M. Huptych, J. Bakker, J. Belohlavek
520    9_
$a 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 discriminate 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.
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a lidé středního věku $7 D008875
650    _2
$a ženské pohlaví $7 D005260
650    12
$a zástava srdce mimo nemocnici $x terapie $7 D058687
650    12
$a mimotělní membránová oxygenace $7 D015199
650    12
$a kardiopulmonální resuscitace $7 D016887
650    _2
$a prognóza $7 D011379
650    _2
$a hypoxie $7 D000860
650    _2
$a retrospektivní studie $7 D012189
655    _2
$a časopisecké články $7 D016428
655    _2
$a práce podpořená grantem $7 D013485
700    1_
$a Rob, Daniel $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Smalcova, Jana $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Havranek, Stepan $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Karasek, Jiri $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Smid, Ondrej $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Brodska, Helena Lahoda $u Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Kavalkova, Petra $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
700    1_
$a Huptych, Michal $u Czech Institute of Informatics, Robotics and Cybernetics (CIIRC), Czech Technical University, Prague, Czech Republic
700    1_
$a Bakker, Jan $u Erasmus MC University Medical Center, Rotterdam, Netherlands; NYU Langone and Columbia University Irving Medical Center, New York, USA; Pontificia Universidad Católica de Chile, Santiago, Chile
700    1_
$a Belohlavek, Jan $u 2(nd) Department of Medicine - Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic. Electronic address: jan.belohlavek@vfn.cz
773    0_
$w MED00004106 $t Resuscitation $x 1873-1570 $g Roč. 192 (20230811), s. 109935
856    41
$u https://pubmed.ncbi.nlm.nih.gov/37574002 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20240109 $b ABA008
991    __
$a 20240213093435 $b ABA008
999    __
$a ok $b bmc $g 2049479 $s 1210581
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2023 $b 192 $c - $d 109935 $e 20230811 $i 1873-1570 $m Resuscitation $n Resuscitation $x MED00004106
LZP    __
$a Pubmed-20240109

Najít záznam

Citační ukazatele

Možnosti archivace